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17 May 2017
Microsporidial keratoconjunctivitis  

Causative agent

Keratoconjunctivitis is an inflammation of the cornea and conjunctiva. Cornea is the transparent front part of the eye whereas conjunctiva lines the inner eyelids and covers the white part of the eyeball. Microsporidial infection is one of the potential causes of keratoconjunctivitis.

Microsporidia are a group of parasites which may cause systemic diseases or localised diseases such as keratoconjunctivitis. Microsporidial keratoconjunctivitis was previously more common in immunocompromised persons, but in recent years it has been increasingly reported in healthy individuals. It may occur as an isolated condition, or may present as part of systemic infection. Risk factors may include having eye trauma, wearing contact lenses, using steroid eye drops and being exposed to unclean water, soil or mud.

Clinical features

Clinical symptoms include foreign body sensation, eye pain, redness and occasionally visual blurring. Some affected persons may experience intolerance to light, tearing, swelling of eyelid, and itchiness. Diagnosis is made by ocular surface scraping and staining.

Mode of transmission

Spores of Microsporidia can be found in the environment and soil. Keratoconjunctivitis can occur when unclean water, soil or mud enters the eyes. It has been associated with sports held in muddy fields, e.g. rugby. 

It has not been reported that microsporidial keratoconjunctivitis can be transmitted from person to person.

Incubation period

Usually 2 – 30 days


It can be treated with antimicrobial eye drops or oral medication.


Avoid playing on very muddy or waterlogged pitches for sports involving contact with soil or mud. If it cannot be avoided, players are advised to wash their faces and eyes thoroughly and immediately afterwards; they should also use different towels for the face and body after engaging in such sports. Members of the public, who have engaged in sports that involve contact with soil or mud, are advised to seek early medical advice if they experience similar symptoms.

People who wear contact lenses should observe good hygiene practice when handling contact lenses.

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