Fungal corneal ulcers are a major blinding eye disease in Asia and have become the most common infectious keratoconus and the most prominent indication for corneal transplantation in many areas of China. With advances in antifungal drugs and surgical techniques, most fungal corneal ulcers can be effectively treated, resulting in improved or restored vision, but unfortunately, there are still some patients with fungal corneal ulcers whose disease is not controlled in time and develops into endophthalmitis, which can even lead to loss of the eye in severe cases. Analysis and identification of the causes and risk factors associated with failed treatment of fungal corneal ulcers would help to predict and detect endophthalmitis in time to avoid these unfortunate blindness events. The results of the study showed that there are three main reasons for the development of endophthalmitis in patients with fungal corneal ulcers: first, the low rate of correct diagnosis at the first visit to primary care hospitals, which leads to delayed disease; second, the presence of drug-resistant fungi and the use of non-sensitive drugs; and third, the poor socioeconomic conditions of patients with fungal corneal ulcers, which makes it difficult for them to seek timely medical care and afford treatment, thus losing the best time for treatment. Thus, improving the level of treatment in primary care hospitals, developing inexpensive and effective antifungal drugs, paying attention to drug sensitivity testing, and improving the social security system and referral system are effective measures to avoid treatment failure of fungal corneal ulcers.