This study aimed to describe clinical characteristics, prognosis, and therapeutic approaches for central corneal degeneration syndrome (CCDS) in dogs. 11 eyes from 9 client-owned dogs diagnosed with CCDS between 2015 and 2024. CCDS was diagnosed on the basis of the presence of central corneal facets that progressively deepened and widened in the absence of corneal ulceration. The mean age at diagnosis was 14.2 years (range, 10 to 17 years). At the time of diagnosis, the facet depth was < 50% in 5 eyes, between 50% and 90% in 4 eyes, and > 90% in 2 eyes. The lesions were located in the axial cornea in 5 eyes and in the paraxial cornea in 6 eyes. At the final follow-up (mean follow-up period, 500.2 days; range, 87 to 1,195 days), progression of the facet depth to > 90% was observed in 10 of 11 eyes. Corneal perforation occurred in 3 eyes, and 2 unperforated eyes underwent corneoconjunctival transposition, resulting in restoration of normal corneal thickness. CCDS is a rare condition in dogs, characterized by progressive thinning of the axial or paraxial corneal stroma without evidence of corneal ulceration, leading to the formation of corneal facets, potentially resulting in corneal perforation. Our findings suggested that CCDS occurs exclusively in older dogs and may be bilateral in some cases. When there is a risk of corneal perforation, surgical intervention, such as corneoconjunctival transposition, is recommended.

Topical polyhexamethylene biguanide (PHMB) 0.08% (AKANTIOR®, SIFI Italy) is the only licensed medicinal product for the treatment of Acanthamoeba keratitis (AK), demonstrating an 84.9% cure rate in a pivotal clinical trial. This study aimed to evaluate its effectiveness and safety in a routine clinical practice. We retrospectively reviewed patient charts from ten Italian centers for the treatment of AK with PHMB 0.08% monotherapy. The treatment protocol followed that used in the pivotal trial. The primary outcome was medical cure, defined as a healed epithelium without inflammation and treatment for at least fourweeks. Treatment failure was defined as the need for surgery or the use of alternative or additional anti-amoebic treatments (AAT). Secondary outcomes included best-corrected visual acuity (BCVA), time to cure, pain, and corneal scarring. Thirty-nine patients (M/F = 14/25) were evaluated. AK was confirmed by confocal microscopy ± polymerase chain reaction or culture in all cases. Sixteen (41%) had stage 3 AK. Thirty-five (89.7%; 95% confidence intervals 80.2-99.3) achieved medical cure. Four failures occurred: three required corneal surgery and one additional AAT. At the end of treatment, mean (SD) LogMAR BCVA was 0.7 (0.8); the median time to cure was 95days (Q1-Q3: 63-140days). Two patients (5.6%) reported residual pain, and 27 (73.0%) had corneal scarring. Four serious adverse events (three hypopyon, one corneal perforation) were reported and considered unlikely to be treatment-related. AKANTIOR cured approximately 90% of patients with AK, indicating that the efficacy observed in the clinical trial can be replicated in clinical practice. ClinicalTrials.gov identifier, NCT06641882.

Neisseria gonorrhoeae, the causative agent of the sexually transmitted infection gonorrhea, can infect intact corneal epithelium, leading to inflammation, corneal perforation, and blindness. Models for studying this type of gonococcal infection are few and limited. We have tested stratified, polarized cornea models based on an immortalized hTCEpi corneal epithelium cell line for infection research using four derivatives of the N. gonorrhoeae MS11 strain that differ in pilus expression. We show that bacterial adherence depends on the functional type IV pilus in the early stages of infection, and that the formation of bacterial microcolonies and biofilms on the model surface leads to tissue destruction. The infection induces a specific cytokine response characterized by an increase in the secretion of IL-8 and tumor necrosis factor (TNF)-α, but not of IL-6. The testing of trifluoperazine, a drug that induces pilus retraction, on infected corneal tissue models showed that the drug strongly diminished the number of adherent gonococci only when applied simultaneously with bacteria, and not when bacteria were allowed to form microcolonies on the tissue surface. Our work describes, for the first time, hTCEpi-based corneal epithelium tissue models as a useful tool for investigating N. gonorrhoeae infection, with potential for application in high-throughput studies and drug screening.

This report discusses a case of multidrug-resistant fungal keratitis associated with contact lens use, complicated by corneal perforation and managed with cyanoacrylate tissue adhesive application. A 51-year-old previously healthy female patient with a history of extended-wear soft contact lens use for approximately five years was referred to our clinic due to decreased vision in her left eye over three weeks. Her visual acuity was 20/20 in the right eye and hand motion in the left eye. Slitlamp examination revealed an expansive infiltrate involving all layers of the cornea of the left eye. The infectious pathogen was identified as Fusarium . After one week of medical treatment, corneal perforation occurred in the left eye, leading to the application of cyanoacrylate tissue adhesive to ensure globe integrity in the short term. After six months, slitlamp examination revealed no reactivation, prompting the removal of the cyanoacrylate from the corneal surface. Approximately one year later, tectonic penetrating keratoplasty and phacoemulsification surgeries were performed for visual rehabilitation. Subsequent vision improvement was observed, with the final best-corrected visual acuity (logMAR) of the left eye reaching 0.3. This case study demonstrates the complexity of managing multidrug-resistant fungal keratitis. The authors would like to highlight that the application of cyanoacrylate tissue adhesive is an immediate therapeutic option, due to its anatomical effect on globe integrity and potential antifungal properties, which can help reduce the risks associated with corneal transplantation.

Corneal perforations necessitate prompt surgical intervention to restore globe integrity and mitigate the risk of irreversible vision loss. Larger corneal perforations often require more complex surgical strategies, including tectonic patch grafting or penetrating keratoplasty. However, limited availability of donor tissue presents significant challenges in meeting urgency of these cases. We describe an ab interno technique approach for corneal perforation repair, using off-the-shelf human cornea as an alternative viable surgical treatment. The surgery was performed at a tertiary center in the United Kingdom, where Halo (VisionGift, Portland, OR) cornea, made from preserved human corneal tissue, was used for perforation repair. The tissue meets Food and Drug Administration and United Kingdom regulatory standards. An 89-year-old woman presented with a painful, red left eye associated with significant vision loss. She had a complex ocular history, including herpes zoster ophthalmicus keratitis. On examination, the left eye visual acuity was reduced to hand motion with an inferior corneal perforation. Surgical management involved placement of the Halo cornea disc internally over the defect with gas tamponade. At 1 week, the patient's left eye vision had improved to 6/24, with intraocular pressure of 10 mm Hg. Nine months postsurgery, the left eye's visual acuity improved to 6/9, with no graft detachment, inflammation, or vascularization observed. This case highlights the successful use of a Halo cornea graft for the management of a large peripheral corneal perforation in a patient with complex ocular pathology. This technique would be of particular interest to ophthalmologists who manage corneal perforations.

Corneal perforation can significantly undermine corneal integrity in patients with severe ocular surface disease (OSD) and escalate to serious ocular sequelae and vision loss. The primary objective of this study is to report the technique and outcomes of non-Descemet stripping automated endothelial keratoplasty using the suture pull-through insertion method for the treatment of perforation in the setting of severe OSD rather than traditional penetrating keratoplasty. Three patients with corneal perforation complicated by severe OSD who underwent non-Descemet stripping automated endothelial keratoplasty at the Illinois Eye and Ear Infirmary between May 2023 and January 2025 were reviewed retrospectively. Information about preoperative patient's characteristics, surgical technique, and postoperative outcomes was extracted. All three patients achieved structural integrity with successful sealing of the perforation at the last follow-up. Postoperatively, all grafts remained attached in the area of perforation. No signs of infection or rejection were observed in any operative eye. Best-corrected visual acuity significantly improved in most cases. Endothelial keratoplasty with amniotic membrane transplantation offers an alternative approach for the treatment of perforation in patients with severe OSD and can be considered in selected cases to avoid further compromise to corneal nerves and epithelial complications that are frequent with full-thickness grafting in these patients.

To describe clinical characteristics, patterns, and management options in benoxinate-induced keratopathy. Retrospective single-center study in which patients using benoxinate hydrochloride 0.4% for greater than 1 month and present with keratopathy and/or corneal complications were enrolled. A total of 36 eyes were included, 90.5% belonged to welders. Median corrected distance visual acuity (CDVA) was 2.3 logMAR (hand motion). Secondary corneal abscess was present in 47.2% of eyes and 66.7% of eyes showed ring-shaped corneal deposits. Approximately 13.9% had corneal perforation at presentation and 22.3% had marked corneal thinning. All eyes except one had varying degrees of epithelial defects, mean defect 50.7±38.1 mm 2 . Approximately 47.2% received medical treatment and 52.7% were treated surgically. Size of epithelial defect was correlated to CDVA and presence of abscess ( P =0.007 and 0.041). Choice of management was affected by size of epithelial defect and CDVA ( P <0.001 and=0.006). CDVA did not improve after reepithelialization ( P =0.157). Benoxinate-induced keratopathy is a potentially blinding and preventable disease. Stricter laws preventing over the counter availability is needed.

The 2023 Pseudomonas aeruginosa keratitis outbreak linked to contaminated artificial tears underscored the need for new therapies against extensively drug-resistant ocular pathogens. In vitro data suggested additive or synergistic activity between the siderophore-cephalosporin cefiderocol (FDC) and either moxifloxacin (MOX) or polymyxin B sulfate (PB). Here, we tested whether combining FDC with the commercial formulations of MOX (0.5%) or PolyTrim (PT; PB 10,000 U/mL + trimethoprim 0.1%) improved in vivo outcomes. New Zealand White rabbits were injected intrastromally with 5000 CFU of Pseudomonas aeruginosa strain CDC1270. After 16 hours, established infections were treated every 30 minutes for 8 hours with FDC, followed 5 minutes later by MOX or PT. Additional groups received monotherapies or saline. Bacterial burden (CFU/cornea) and anterior chamber cultures were determined, and ocular inflammation was assessed. FDC + MOX reduced bacterial burden by 2.8 log10 CFU, outperforming FDC and MOX monotherapies, although no eyes were sterilized. PT monotherapy produced a significant 3.2 log10 reduction in CFU. The FDC + PT combination yielded the most potent activity, with almost 6.9 log10 reduction and sterilization of 10 of 12 corneas. Notably, anterior chamber invasion occurred in saline and MOX groups but in none of the FDC-containing groups, and perforations were absent in all FDC and PT treatments. FDC + PT was superior to monotherapies and to FDC + MOX, achieving frequent sterilization and preventing intraocular spread and corneal perforations. These data support PT alone or in combination with FDC as promising therapeutic candidates for the treatment of XDR P. aeruginosa keratitis.

Introduction Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease primarily affecting synovial joints. Ocular involvement is among the most important extra-articular manifestations of RA. The most common ophthalmic manifestation is dry eye syndrome in the course of secondary Sjögren’s disease. Necrotic sclerosis and peripheral ulcerative keratitis are particularly aggressive inflammatory processes that may lead to corneal thinning, perforation and irreversible vision loss. Case description An 88-year-old woman has been under the care of the Department of Ophthalmology for 24 years. In 2002, she presented on an emergency duty for ophthalmologic consultation due to a corneal ulcer in the right eye complicated by subsequent corneal perforation. The condition developed in the course of severe dry eye syndrome secondary to RA. During the course of her medical history, the patient underwent 5 procedures involving the transplantation of human amniotic membrane onto the cornea in the right eye and 3 in the left eye, as well as 5 penetrating corneal transplantation in the left eye and 2 in the right eye. Despite numerous attempts to improve visual acuity, a satisfactory visual outcome has not been achieved. However, preservation of both eyeballs and low visual acuity was maintained. Each surgical intervention was complicated by impaired wound healing and recurrent corneal ulcerations. The patient has been on long-term systemic treatment for rheumatoid arthritis and, following high-risk corneal grafts, required systemic glucocorticosteroid and immunosuppressive therapy. This may have contributed to other systemic complications, including myocardial infarction, mesenteric infarction with intestinal perforation, and lower limb ischemia, that occurred during the patients long term follow-up. The above-mentioned complications may also be attributable to advanced autoimmune disease. Conclusions Despite advances in disease-modifying drugs and biological drugs, severe ophthalmic complications remain a clinical challenge. Early and close cooperation between a rheumatologist and an ophthalmologist is crucial to prevent catastrophic outcomes. Rheumatoid arthritis is one of the autoimmune diseases that may lead to irreversible vision loss

Corneal ulcers in dogs are frequently associated with microbial contamination, which may compromise healing and lead to severe ocular complications. The use of tilapia skin as a biotechnological graft has emerged as a promising alternative for corneal repair; however, its influence on the ocular microbiota remains poorly understood. This study aimed to evaluate the bacterial microbiota of canine corneal ulcers treated with tilapia skin graft, focusing on the presence and evolution of microorganisms during the surgical and postoperative periods. Microbiological samples were collected from dogs presenting deep corneal ulcers or perforations, using sterile swabs applied to both central and peripheral regions of the lesion. Samples were transferred to Stuart transport medium and subjected to standard microbiological analysis. Initial cultures revealed the presence of clinically relevant bacteria, including Pseudomonas spp. and Klebsiella spp., commonly associated with ocular infections. Postoperative evaluation demonstrated a notable reduction in bacterial growth, with no detectable microbial proliferation after 20 days of treatment under topical antibiotic therapy. These findings suggest that the use of tilapia skin graft does not promote microbial persistence and may be associated with a favorable microbiological environment during the healing process. This study highlights the importance of monitoring ocular microbiota in corneal repair procedures and supports the safety of tilapia skin as a biotechnological material in veterinary ophthalmology. Further studies with larger sample sizes are required to confirm these findings and explore long-term microbiological dynamics.

Lamellar ichthyosis is a rare congenital disorder of keratinization frequently associated with ocular complications, most commonly cicatricial ectropion and exposure keratopathy. We present a case of severe mixed exposure-related and neurotrophic keratopathy with marked corneal thinning in a 61-year-old man with genetically confirmed lamellar ichthyosis. At presentation, the best-corrected visual acuity (BCVA) in the right eye was limited to hand motion (logMAR 2.3). Slit-lamp examination revealed a large central to inferocentral corneal ulcer measuring approximately 3 × 4 mm with severe stromal thinning in the setting of marked lower eyelid ectropion, incomplete eyelid closure, and chronic ocular surface exposure, while anterior segment optical coherence tomography (AS-OCT) demonstrated a minimal corneal thickness of approximately 165 µm. Microbiological swabs obtained from the conjunctival sac were negative, and no purulent discharge, hypopyon, or anterior chamber inflammatory reaction was present, making active infectious keratitis unlikely. Corneal sensitivity measured with Cochet-Bonnet esthesiometry at presentation, centrally and in all four peripheral quadrants of both eyes, was markedly reduced, more severely in the affected right eye, supporting the presence of a severe neurotrophic component contributing to impaired corneal healing. Intensive conservative therapy including preservative-free lubricants, dexpanthenol gel, autologous serum eye drops, topical insulin, prophylactic antibiotics, and systemic doxycycline was initiated. Serial AS-OCT imaging demonstrated progressive structural recovery, with corneal thickness increasing to 438 µm after one month of treatment and complete corneal epithelialization. The BCVA improved to 0.2 Snellen (0.7 logMAR). This case highlights the diagnostic value of multimodal anterior segment imaging in monitoring severe mixed keratopathy with advanced corneal thinning and demonstrates that intensive conservative therapy may stabilize the ocular surface and prevent corneal perforation in patients with lamellar ichthyosis.

Rapidly progressive infectious keratitis may involve the anterior uveal tract and lead to anterior segment inflammation, resulting in severe structural damage of the cornea and potentially causing corneal perforation or endophthalmitis if not promptly treated. We report the case of a 63-year-old male admitted to the Emergency Ophthalmology Department of the University Clinical Center in Katowice, Poland, with a rapidly progressive corneal ulcer of the left eye that had not responded to two weeks of outpatient topical antibiotic therapy. The condition developed after ocular trauma sustained while chopping wood. At presentation, visual acuity was limited to light perception with preserved projection. Multimodal imaging, including slit-lamp examination, anterior segment optical coherence tomography (AS-OCT), and in vivo confocal microscopy, revealed extensive corneal ulceration with severe stromal destruction, progressive corneal melting, and marked anterior segment inflammation, with an imminent risk of perforation. Microbiological cultures identified Pseudomonas aeruginosa. Despite intensive empiric topical antimicrobial therapy targeting both bacterial infection and a possible fungal component related to trauma with organic material, rapid clinical deterioration necessitated emergency therapeutic penetrating keratoplasty (PK). The procedure resulted in rapid resolution of inflammation and improvement in visual acuity, with best-corrected visual acuity (BCVA) reaching 0.3 logMAR during follow-up. At the three-month follow-up, the corneal graft remained clear with stable visual acuity and no recurrence of infection. The patient remains under regular long-term follow-up, with ongoing monitoring of graft clarity, intraocular pressure (IOP), and visual function. This case differs from routine presentations of infectious keratitis by demonstrating exceptionally rapid stromal melting despite promptly initiated empiric topical therapy. Multimodal imaging, particularly AS-OCT provided clinically meaningful information by revealing structural instability and an imminent risk of perforation not fully appreciable on slit-lamp examination, thereby supporting timely urgent keratoplasty. These findings highlight the practical diagnostic value of imaging-based assessment in advanced infectious keratitis and underscore its role in guiding surgical decision-making in eyes at high risk of corneal perforation.

Corneal perforations are defined by a total loss of the various corneal layers of varying significance, which may be of infectious, traumatic, trophic, immunological, or inflammatory origin, affecting both the functional and anatomical prognosis of the eye. Management involves closing the corneal perforation as soon as possible for optimal anatomical and functional recovery. Objective: To define Tenon patch grafting as an effective and promising surgical technique in the management of corneal perforations, especially in developing countries with good anatomical and functional results. Methods: Prospective study collecting epidemiological and clinical data as well as anatomical and functional outcomes of 24 patients treated with this surgical technique over a one-year period, between January 2021 and December 2021; whose follow-up was conducted both by the slit lamp and anterior segment OCT during the follow-up period. Results: The Tenon's capsule graft has demonstrated its effectiveness in the management of corneal perforations, with immediate closure of the corneal perforation achieved in 23 cases, representing 95.83% of our study. Regarding the functional outcomes of our series, the mean final visual acuity was 2.04 Log MAR. Our study has demonstrated that the OCT of the anterior segment constitutes a non-invasive, effective, and objective means in the follow-up period. Conclusion: Tenon graft is effective, promising, and less costly surgical technique, as shown by several studies, particularly useful when corneal grafts are not available and especially in emergencies.

Perforated Mooren's ulcer in African melanoderm: Report of 18 cases.

Therapeutic success in canine corneal ulcers depends on appropriate antimicrobial selection and reliable at-home drug delivery. However, veterinary data on owner adherence remain limited and are largely self-reported. Evidence from human ophthalmology indicates that dosing frequency, follow-up interval, and hands-on technique training strongly influence treatment outcomes. This viewpoint advocates a shift from drug-centered to delivery-centered management and proposes a testable four-part Clinical Adherence Bundle (CAB-4): scheduling timely rechecks within 14 days, minimizing dosing frequency when microbiologically appropriate, providing standardized staff-led technique education with written or video materials, and anticipating medication needs to prevent stockouts. Each component is designed to be measurable in routine practice, auditable within clinical workflows, and scalable across both referral and primary-care settings. Finally, we propose a pragmatic research framework to prospectively evaluate the CAB-4 by linking adherence metrics with objective clinical outcomes, including epithelial healing time and corneal perforation.

Ocular diseases in New World camelids presented to the Veterinary University in Vienna: 68 cases (2009-2025).

Abstract Purpose This retrospective study aims to evaluate the clinical outcomes of a customised “banana-shaped” anterior lamellar keratoplasty technique in the treatment of peripheral corneal ulcerative perforations in six patients treated at a tertiary care center in Switzerland over a one-year period. Methods In this retrospective observational study conducted between December 2023 and December 2024 at a tertiary care center in Switzerland, six patients (5 male, aged 48 – 86 years) with peripheral corneal ulcer perforations underwent a customized crescent-shaped (“banana-shaped”) anterior lamellar keratoplasty. Three patients had perforations secondary to peripheral ulcerative keratitis (PUK) of autoimmune origin, one patient presented with a perforated neurotrophic corneal ulcer, another patient had a perforation due to surgically induced necrotizing scleritis, and the last patient had a perforation secondary to gonococcal keratoconjunctivitis. The corneal grafts were tailored to the size and location of the peripheral defects while preserving the central cornea. All patients were treated with topical corticosteroids and antibiotics postoperatively, with systemic therapy adjusted to the etiology of the ulceration. Outcomes assessed included graft clarity, epithelial healing, anatomical integrity, and best spectacle corrected visual acuity (BSCVA), with follow-up ranging from 6 to 12 months. Results Anatomical integrity of the globe was successfully restored in all six patients. All grafts remained clear, and epithelial healing was achieved within 10 days to 4 weeks. There were no cases of graft rejection or recurrent inflammation. Final BSCVA ranged from 0.7 to 0.3 logMAR. Conclusion Customised “banana-shaped” anterior lamellar keratoplasty is a safe and effective surgical approach for the management of peripheral corneal ulcerative perforations, particularly in cases of PUK. This technique allows localised structural repair while preserving the central visual axis, resulting in favorable anatomical and visual outcomes.

There is a global shortage of donor tissue for corneal transplantation. Long-term stored ethanol-preserved corneoscleral tissue may help address this shortage, particularly in emergency cases of corneal perforation. This retrospective study analyzed tectonic keratoplasties for perforated corneal ulcers performed between January 2018 and December 2022. A total of 20 surgeries in 14 patients (6 female, 8 male) using ethanol-conserved corneoscleral tissue were included. Surgical, postoperative, and follow-up data were analyzed until December 2024, including graft storage duration, epithelialization, graft survival, complications, and best-corrected visual acuity. Outcomes were considered favorable if only planned surgery or no further surgery was required, and unfavorable if additional emergency intervention was necessary. The mean patient age was 83.5 (interquartile range 69.2-87.8) years (range 40.2-89.8). The cause of corneal perforation included immune-mediated corneal ulcers n = 8 (40%), neurotrophic corneal ulcers n = 7 (35%), herpetic corneal ulcerations n = 4 (20%), and fungal keratitis n = 1 (5%). The median graft size was 4.0 mm, with a median storage duration of 71.5 days (range 4-346). Graft survival resulted to 23.2 ± 17.4 months. A favorable outcome was achieved in 12 cases (60%). Epithelial closure was observed in all cases within 15 days. Best-corrected visual acuity improved from 1.7 ± 0.8 logMAR to 1.1 ± 0.7 logMAR. Ethanol-preserved corneoscleral tissue is safe and feasible for emergency tectonic keratoplasty. Its extended storage capacity may aid in the current global shortage of donor corneas.

Corneal perforation is a sight-threatening ophthalmic emergency caused by trauma, infection, autoimmune disease, or ocular surface disorders. Early recognition and timely management are critical to maintain globe integrity and prevent complications. This review synthesizes current knowledge on the diagnosis and management of corneal perforations. A narrative review of the literature was conducted using PubMed, Scopus, Web of Science, and Google Scholar through 2025. Keywords included "corneal perforation," "corneal thinning," "corneal melt," "ulcerative keratitis," "tissue adhesive," "amniotic membrane transplantation," and "keratoplasty." English-language original studies, case series, and reviews were included, and unrelated reports were excluded. Data were qualitatively synthesized due to heterogeneity in study designs. Illustrative clinical cases from King Khaled Eye Specialist Hospital were included to demonstrate real-world diagnostic and therapeutic approaches. Major causes of corneal perforation include infectious keratitis, autoimmune/inflammatory diseases, neurotrophic keratopathy, trauma (including iatrogenic), and degenerative or exposure-related conditions. Common clinical features are rapid vision loss, severe ocular pain, and tearing. Evaluation requires a careful, minimally manipulative examination with adjunctive imaging and systemic assessment when indicated. Management options include tissue adhesives, amniotic membrane grafts, platelet-rich plasma, lamellar or penetrating keratoplasty, and conjunctival flaps. Recent advances in biological adhesives, amniotic membrane techniques, and anterior segment imaging have expanded treatment options and improved outcomes. Follow-up is guided by slit lamp examinations and imaging. This review integrates recent evidence and evolving strategies to provide clinicians with a structured, stepwise framework for managing corneal perforations.

BACKGROUND: Linear interstitial keratitis (LIK) is a rare variant of interstitial keratitis and is characterised by a sharply demarcated stromal band of opacity with uncertain pathophysiology and no consensus management. We report the largest contemporary study to characterise phenotype, diagnostics, treatment, and outcomes. METHODS: This is a retrospective, investigator-initiated study across two university hospitals. Extracted data included demographics, clinical features, microbiology/serology, anterior segment imaging, treatments and outcomes. RESULTS: Six unilateral cases were included (five males, one female). LIK presented as a sharply demarcated linear stromal opacity of variable, often near limbus-to-limbus, extent. AS-OCT commonly localised the lesion to the anterior stroma, while IVCM (when performed) suggested broader stromal activation, despite an anterior-predominant OCT signal. Corneal scraping, as well as systemic workup, was mostly unremarkable. Management frequently combined topical corticosteroids with topical antimicrobials and/or systemic antivirals. One patient received steroid-sparing maintenance with topical 0.1% cyclosporin. Visual outcomes were generally favourable: four eyes achieved or maintained corrected Snellen ≥ 1.0. However, two eyes declined (to 0.6 and 0.5), and one patient experienced two corneal perforations during a relapsing course. CONCLUSIONS: LIK is a recognisable, predominantly anterior stromal, phenotype of interstitial keratitis affecting predominantly younger patients. An immune-stromal process is assumed, but a clear cause could not be established despite extensive testing. Most cases are steroid-responsive but may relapse, supporting slow tapering and consideration of steroid-sparing prophylaxis. Close monitoring is warranted when thinning, neovascularisation, or recurrence is present.