5 Key Takeaways

• 1

  A 9-year-old girl with persistent keratoconjunctivitis was diagnosed with microsporidial keratoconjunctivitis after failing allergy treatment.

• 2

  In vivo confocal microscopy and anterior segment optical coherence tomography provided diagnostic insights but could not directly identify microsporidia.

• 3

  Metagenomic next-generation sequencing confirmed the diagnosis of microsporidial keratoconjunctivitis by identifying E hellem.

• 4

  The patient improved significantly with targeted therapy, achieving 20/20 visual acuity and resolution of symptoms by day 14.

• 5

  The case highlights the need to consider microsporidial infection in patients with unresponsive keratoconjunctivitis, especially with lens wear.