case_images: PMC10074259_01
case_images: Diffuse superficial corneal haze over DALK.
case_images: cop528894_f01.jpg
case_images: PMC10074259_01_cop528894_f01.jpg
case_images: F1
case_images: On examination, the visual acuity was 20/50 and slit-lamp examination indicated follicular conjunctivitis, mild diffuse subepithelial haze, anterior chamber reaction with keratic precipitates (shown in Fig. 1).
case_images: Clinical presentation of microsporidial keratitis in the right eye. a The presentation at the emergency with multiple superior white corneal infiltrates. b After 2 weeks with increased size and density of the superior stromal infiltrate. c Clear graft with no recurrence 6 months after therapeutic lamellar keratoplasty.
case_images: cop528894_f02.jpg
case_images: PMC10074259_01_cop528894_f02.jpg
case_images: F2
case_images: Slit-lamp examination indicated moderate conjunctival injection, diffuse subepithelial haze on the graft with multiple white infiltrates, mild superior graft edema, corneal epithelial defect, and occasional cells (Fig. 2a). After 2 weeks, the visual acuity decreased to hand motion with an increase in the size and density of the superior superficial infiltrate and epithelial defect (shown in Fig. 2b). One year after therapeutic DALK, the patient reported no similar episodes and the graft is clear with no signs of recurrence (shown in Fig. 2c).
case_images: Histopathology of microsporidial keratitis over DALK graft. a Modified Ziehl-Neelsen stain showed bright red spores that are visible against a blue background (magnification, x1,000). b Masson's trichrome spores appeared red against a blue background with ill-defined internal morphology (magnification, x1,000).
case_images: cop528894_f03.jpg
case_images: PMC10074259_01_cop528894_f03.jpg
case_images: F3
case_images: Modified Ziehl-Neelsen stain (shown in Fig. 3a) and Masson's trichrome stain (shown in Fig. 3b) showed bright red spores, visible against a blue background, consistent with microsporidial infection.