DIAGNOSIS OF MICROSPORIDIAL KERATITIS BY CONFOCAL MICROSCOPY AND THE CHROMATROPE STAIN

PURPOSE: To illustrate the value of confocal microscopy and chromatrop e stain in the diagnosis of microsporidial keratitis. METHODS: In vivo confocal microscopy was performed on a man with the human immunodefic iency virus who had severe bilateral epithelial keratitis refractory t o topical antibacterial medications. The results were compared to conj unctival scrapings stained with the chromatrope-based Weber stain. RES ULTS: Confocal microscopy demonstrated many small, intraepithelial opa cities of the corneal epithelium, which were suggestive of Microsporid ia. Results of the chromatrope stain of conjunctival scrapings confirm ed the diagnosis of microsporidial keratitis. CONCLUSIONS: Rapid diagn osis allowed prompt initiation of topical fumagillin, which permitted rapid, long term control of the symptoms of microsporidial keratitis.