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Year : 2021  |  Volume : 1  |  Issue : 4  |  Page : 651-653

Successful medical management of bilateral microsporidial stromal keratitis: A case report and review of literature

1 Cornea and Anterior Segment Services, The Cornea Institute, LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India
2 Ocular Microbiology Service, LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India

Correspondence Address:
Dr. Merle Fernandes
Cornea and Anterior Segment Service, The Cornea Institute, L V Prasad Eye Institute, Hanumanthawaka Jn, Visakhapatnam - 530 040, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_3219_20

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An 81-year-old gentleman with a vague history of dust falling into the eyes presented with a white lesion in the left eye for 5 months. Both eyes showed two foci of central dense stromal infiltrates with keratic precipitates. Suspecting herpes simplex virus (HSV) keratouveitis, topical steroids, and antiviral eye ointment were started. A month later, he developed unilateral microsporidial keratoconjunctivitis with persistent bilateral deep stromal keratitis. The corneal scrapings revealed microsporidial spores on 10% Potassium hydroxide (KOH)with Calcofluor White Stain. Topical 1% voriconazole eye drops for 4 months in the right eye, a combination of 1% voriconazole and Natamycin eye drops for 9 months in the left eye and oral albendazole 400 mg twice daily for 3 weeks resulted in complete resolution. There were no recurrences over 1 year. We present a literature review of the medical management of microsporidial stromal keratitis highlighting our case with bilateral disease successfully managed medically with antifungal therapy.

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