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Nocardia keratitis after small incision lenticule extraction (SMILE)
  1. Mohammed H Alhemyari1,
  2. Pranitha Satarasi1,
  3. Joveeta Joseph2 and
  4. Bhupesh Bagga3
  1. 1 Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
  2. 2 Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, India
  3. 3 Shantilal Shanghvi Cornea Institute, The Ramoji Foundation Centre for Ocular Infections, L V Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Bhupesh Bagga; bhupesh{at}


We report the case of a female patient in her late 20s who visited the clinic with concerns about poor vision, redness, watering and a burning sensation in her left eye 2 weeks after undergoing a small incision lenticule extraction. She had no history of systemic illness or immunosuppressed status. On slit lamp examination, she was found to have corneal stromal infiltrates in the interface at multiple locations. Given the clinical diagnosis of microbial keratitis, corneal scraping of the interface infiltrate was performed and sent for microbiological examination revealing gram-positive, thin, beaded filaments that were acid-fast positive and later identified by growth in culture media as Nocardia species. This case was managed successfully with the use of topical amikacin and systemic trimethoprim-sulfamethoxazole with complete resolution of infection.

  • Eye
  • Infections
  • Anterior chamber

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: All authors designated as authors qualify for authorship. Each author has participated sufficiently in the work to take public responsibility for appropriate portions of the content. The patient was managed by MHA, PS and BB. The manuscript was conceptualised by MHA, PS, JJ and BB and drafted by MHA and BB. The article was edited and finalised by MHA and BB. The following author gave final approval of the manuscript: BB.

  • Funding This study was funded by Hyderabad Eye Research Foundation (LEC-BHR-R-12-23-1160).

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.