Stromal microsporidial keratitis successfully treated with medical therapy

PURPOSE: To report a case of severe stromal microsporidal keratitis successfully treated with oral albendazole and topical voriconazole. OBSERVATIONS: A 71-year-old man presented with progressive vision loss and corneal opacification for one year. Initial visual acuity was counting fingers attributed to a dense subepithelial opacification. Confocal microscopy and subsequent corneal biopsy lead to the diagnosis of microsporidial keratitis. The patient completed a four-week course of oral albendazole and topical voriconazole which resulted in resolution of the corneal opacification and improvement in visual acuity to 20/250. CONCLUSIONS AND IMPORTANCE: A four-week course of oral albendazole and topical voriconazole was an effective treatment for severe stromal microsporidial keratitis.