Delayed-Onset Actinomyses Keratitis after LASIK

To present a case of delayed-onset unilateral keratitis due to Actinomyses israelii after laser in situ keratomileusis. Patient and A 28-year-old lady was referred to our clinic with foreign body sensation and mild blurring of vision in her left eye. She had undergone bilateral LASIK about five months ago. On examination, there was an area of infiltration at the interface with an overlying area which stained with fluorescein in the center of the cornea. The LASIK flap was elevated and scraping of the interface and the bed was performed. Results of culture and smear showed Actinomyses israelii as the causative agent. Antibiotic treatment was initiated according to the sensitivity results and the infection was controlled. Actinomyses must be considered in differential diagnosis of delayed-onset infectious keratitis after LASIK in addition to fungal and atypical Mycobacteria. Elevation of the flap and scraping the involved area can be helpful in obtaining specimens for culture and smear as well as reducing the infectious bulk. Adherence to aseptic techniques is mandatory for prevention of infections.