RT Journal Article SR Electronic T1 A case of stromal microsporidiosis: medical strategies employed for successful resolution JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e246233 DO 10.1136/bcr-2021-246233 VO 15 IS 2 A1 Anita Raghavan A1 Devi Rosette Raja A1 Narendran Venkatapathy A1 Ram Rammohan YR 2022 UL http://casereports.bmj.com/content/15/2/e246233.abstract AB We describe the diagnosis and successful management of a case of stromal microsporidiosis, an important emerging ocular disease. Stromal microsporidiosis is recalcitrant and very often requires therapeutic keratoplasty for effective eradication. We successfully managed a steroid-treated case diagnosed only after 9 months, with a combination of polyhexamethyl biguanide 0.04%, chlorhexidine 0.04% and fluconazole 0.3% eye drops supplemented with tablet albendazole. However, complete resolution was achieved only after epithelial debridement. Toxicity due to the drugs was not noted. Diagnostic delays, steroid use and inappropriate therapy are commonly observed in stromal microsporidiosis. In spite of these potential disadvantages, our case responded well with complete eradication of the infection. The disease being fairly indolent and slowly progressive, medical therapy should be continued, in the absence of progression or other complications. Epithelial debridement may facilitate healing.