**4.4 Voriconazole**

Voriconazole, a newer-generation triazole, with excellent ocular penetration and broad spectrum. Most of fungal isolates commonly implicated in keratitis were found to be susceptible to voriconazole**.**

Voriconazole has been reported to be effective in the treatment of fungal keratitis caused by different species and in cases not responding to other antifungal like natamycin and amphotericin [79–85]. Voriconazole has good intraocular penetration following oral administration. Advantage of oral administration is that it may provide steadier drug levels at the site of infection. Theil et al. compared aqueous samples after topical and oral voriconazole found that topical administration of voriconazole resulted in highly variable aqueous concentrations with troughs well below the minimum inhibitory concentration at which 90% of fungal isolates are inhibited (MIC90). Whereas, oral voriconazole provided relatively constant therapeutic concentration [84]. Many case reports reported successful treatment with topical voriconazole in conjunction oral or intravenous voriconazole [85, 86].
