It is often difficult for a clinician to decide which antifungal to use and the route of administration in fungal infections. Current selection of antifungal agents is based on animal experiments, clinical experience, andpublished sensitivity data. 1 , 2 Another problem in the treatment of fungal keratitis is that the corneal epithelium serves as a barrier to the penetration of most topical antifungal agents because the annular tight junctions (zonula occludens) completely surround and effectively seal the superficial epithelial cells. Debridement of the corneal epithelium is often necessary, especially early in the course of treatment, 3 though this may decrease host defenses, increase pain and inflammation, and delay the healing process, lontophoresis is a potential modality for the treatment of fungal keratitis that could increase the penetration of antifungal drugs into the cornea and aqueous humor, 4 , 5 as has been demonstrated with other drugs, in other intraocular tissues. 6 , 7 The following is a report of a case of Paecilomyces keratitis, in which iontophoresis was used to increase topical penetration of miconazole using Coulomb controlled iontophoresis, as well as oral therapy.