Conservative management of Pseudomonal infectious sclerokeratitis

Pseudomonal sclerokeratitis is an uncommon infection with the potential for loss of vision and the eye. A 66-year-old male contact lens wearer presented with a painful red eye diagnosed as sclerokeratitis. An intensive regimen of topical, subconjunctival and oral antibiotics as well as oral steroids was used as primary treatment. An overlying, focal collection of pus was incised and drained on two occasions. After three months of treatment, the infection had resolved and the treatment ceased. The involved sclera demonstrated a focal area of scleromalacia, which has remained stable. Infectious sclerokeratitis can be managed with conservative treatment without the need for surgical debridement and scleral grafting.