Dr.Varshitha Hemanth Vasanthapuram, H18195, Dr. Chintan Malhotra, Dr. Arun K Jain, Mr. Surya Prakash Sharma
Microsporidia are obligate intracellular, spore forming protozoan parasites. Past few decades have seen an increase in number of cases reported.Two clinical patterns have been described- superficial punctate keratitis previously common in immunosuppressed individuals & stromal keratitis in the immunocompetent. Routine microbiological examination is difficult due to scarcity of sample. Tissue biopsy cannot be warranted in all cases. We present a case series of five patients with superficial punctate keratitis with clinical suspicion of microporidial keratitis on slit lamp biomicroscopy,subjected to confocal microscopy and corneal scraping thereafter. In vivo confocal microscopy revealed intraepithelial hyper-reflective dots suggestive of microsporidial spores which was confirmed by classical appearance of non budding uniform oval shaped spores on KOH wet mount and calcoflour white stain. Thus in vivo confocal microscopy is a useful adjunct for an early confirmed diagnosis and treatment.