Bilateral methicillin-resistant Staphylococcus aureus keratitis after corneal crosslinking for keratoconus in a child

We report the case of an 11-year-old boy known to have atopic dermatitis who was referred for management of allergic conjunctivitis, meibomian gland dysfunction, and anterior blepharitis. After achieving quiescence of these ophthalmic manifestations, he was lost to follow-up and subsequently presented with bilateral keratoconus. He developed bilateral keratitis with methicillin-resistant Staphylococcus aureus (MRSA) 1 week after corneal cross-linking. Children with underlying atopic dermatitis are more likely to harbor MRSA on their eyelid margins and conjunctival sacs and are therefore at higher risk of postoperative infection. Prevention and treatment measures, such as preoperative screening and the use of appropriate perioperative antibiotics against MRSA should always be considered in this population.