ABSTRACT
The severity and progression of bacterial keratitis is thus dependent upon the virulence of the pathogenic organism and host factors such as pre-existing contact lens wear, ocular surface disease, eye injury, immunocompromised status and systemic disease. Tectonic keratoplasty is required for cases presenting with corneal perforation and iris tissue prolapse in these severe necrotising ulcers. The patient was also diagnosed with acquired nasolacrimal duct obstruction in the left eye on performing syringing and probing under aseptic precautions. The scraped material revealed growth of Streptococcus viridans on bacterial culture. The hypopyon resolved within a week of therapy and the ulcer healed with leucomatous corneal scarring after around ten weeks of therapy. Slit lamp biomicroscopy of the right eye revealed multiple, irregular grey-white opacities with indistinct borders extending to the corneal periphery and intervening haze consistent with the diagnosis of macular corneal dystrophy.
