Actinomyces Infectious Crystalline Keratopathy

ber, similar to fungi. Recently, microsporidia have been phylogenetically shown to be fungi, and their tissue behavior akin to that of fungi would be expected. Our patient had clinical features of herpetic viral endotheliitis at the initial visit, which improved initially with antiviral treatment. There is a possibility that the patient may have had viral keratitis initially and then became secondarily infected with microsporidium. Also, coinfection by microsporidia with herpes cannot be excluded. Penetrating graft rather than lamellar keratoplasty is recommended for patients with deep stromal involvement to avoid any chance of recurrence in the lamellar bed. In our case, the presence of microsporidial spores in the endothelial exudates highlights the possible penetration of microsporidial spores through intact Descemet membrane, thereby emphasizing the need for penetrating keratoplasty in cases of deep stromal involvement, especially with endothelial exudates. We conclude that endothelial exudates may manifest in microsporidial keratitis, and the spores may be present in the endothelial exudates.