Microsporidial Keratitis

Abstract

Microsporidia is a family of rare, spore-forming organisms which tend to infect humans and animals. In recent decades Microsporidia have attracted greater attention due to their association with immunocompromised patients but the incidence of keratitis in immunocompetent individuals is rare, accounting for 0.4%. This study aims to report two similar cases of keratoconjunctivitis in immunocompetent patients presented with complaints of watering, irritation, redness and pain in the eye. On examination circumcorneal congestion on conjunctiva was present and on slit lamp examination stuck on appearance in corneal stroma was seen. On microscopy Gram stain showed violet colored ovoid spores. Modified acid fast stain showed acid fast bright red spores against blue background. On Giemsa stain blue spore-like structures were seen. These findings were suggestive of microsporidial keratitis and the patients were started on fluconazole eye drops. Patients were reviewed after starting therapy and were symptomatically better and cornea was found to be clear.