Microsporidial keratitis after collagen cross-linking.

PURPOSE: To report a case of infectious keratitis due to Microsporidium after collagen crosslinking (CXL).

METHODS

A 36-year-old man presented with a 3-day history of pain, redness and diminution of vision in his left eye. The patient had received CXL for keratoconus in the left eye 6 days prior to presentation. Best-corrected visual acuity (BCVA) was 20/25 OD and counting fingers OS. Slit lamp examination of the left eye showed a central epithelial defect measuring and multiple stromal infiltrates.

RESULTS

Gram and Giemsa staining of corneal scrapings showed spores characteristic of Microsporidia. Hourly 0.5% moxifloxacin eye drops, 0.5% moxifloxcain eye ointment nocte and oral albendazole 400 mg twice daily were commenced. Corneal debridement was performed twice during the first week. At the end of 6 weeks BCVA was 20/60 in the left eye.

CONCLUSIONS

Microsporidial infection can be confirmed on microbiological examination. Our case responded well to medical treatment alone.