Abstract
Microsporidial stromal keratitis is refractory to topical drugs and is classically described in immunocompetent hosts. A 55-year-old patient with renal transplant and oral immunosuppressants, presented with a 15-day history of redness, pain, and diminution of vision in the right eye. Slit-lamp examination revealed epithelial defect and mid-stromal infiltrate. On corneal scraping, microsporidial spores were observed. The patient was started on topical 0.02% polyhexamethylene biguanide (PHMB) and the infiltrate resolved after 6 weeks of initiation of topical therapy.