Figure 1.

Slit-lamp photographs. Notes: (A) a large stellate-shaped epithelial defect with multiple stromal satellite infiltrates overlying the inferior visual axis on presentation. The grey–white stromal infiltrates had feathery margins and raised sloughy borders with associated conjunctival injection, dilated iris vessels and a mild anterior chamber reaction. (B) Clinical deterioration: enlarging central epithelial defect and coalescing stromal infiltrates with pronounced conjunctival injection, corneal oedema and hypopyon. Poor treatment response required revision of medical management to include broadening antimicrobial cover and treatment consideration of atypical agents including viral, fungal and Acanthamoeba. (C) Therapeutic penetrating keratoplasty performed on day 26. Fungal invasion seen on the iris intraoperatively.