P. insidiosum keratitis is a severe progressive infectious corneal disease that causes vision loss in most patients. Confocal microscopy may provide rapid in vivo visualization of P. insidiosum hyphae in corneal tissues, but it cannot distinguish P. insidiosum from other fungal keratitides. Culture identification with zoospore induction or polymerase chain reaction remains the most reliable means to confirm the diagnosis of P. insidiosum keratitis.

Although no ocular surface infection was observed, the patients under 100% autologous serum eye drops therapy should be closely monitored for clinical evidence of fungal and bacterial infections.

Purpose: To describe the findings of anterior segment optical coherence tomography (AS-OCT) in patients with microsporidial keratoconjunctivitis. Methods: The observational study included 13 eyes from 13 patients. Slit-lamp photography and AS-OCT were performed using the Swept source OCT before corneal scraping. All cases were positive for Gram-chromotrope (modified trichrome) staining for Microsporidia spp. Results: Three significant AS-OCT findings were observed. First, hyperreflective dots were limited to the epithelial layers of the cornea, and second, there were no extensions into the stromal layer in all cases. Last, hyperreflective dots slightly raised above the epithelial surface were observed in most cases (12/13%, 92.3%). Conclusions: AS-OCT represents an alternative, noninvasive tool to diagnose microsporidial keratoconjunctivitis, especially if corneal scraping is not possible.

TPK using glycerol-preserved corneas has a high rate of secondary glaucoma and recurrence of infection with unsatisfactory visual results. These corneas may be used as temporary emergency transplants in infectious keratitis when fresh corneas are unavailable to meet demands.

Loteprednol etabonate was effective in postoperative PRK management and was significantly less likely to produce elevations in IOP than was dexamethasone.