Ocular microsporidiosis comprises two entirely different spectra of disease as keratoconjunctivitis and stromal keratitis. Microsporidial keratoconjunctivitis (MKC) has been increasingly reported in the past two decades, probably due to raised awareness, simpler diagnostic procedures, and a better understanding of the clinical presentation. It is characterized by the presence of raised, coarse, punctate, multifocal, round to oval, greyish-white corneal epithelial lesions which usually evolve into nummular scars before resolution. Conjunctivitis seen is non-purulent and of mild-moderate intensity, with mixed papillary-follicular reaction. The mode of transmission and pathogenesis is poorly understood. Despite lack of inflammatory response, uncommon associations reported were- endotheliitis, corneal edema, limbitis, uveitis, and sub-epithelial infiltrates. There has been no consensus on the management of MKC. It varies from the use of multiple antimicrobial agents to simple lubricants. The majority of the disease goes underdiagnosed or misdiagnosed and treated as adenoviral keratoconjunctivitis, with topical steroids or anti-virals empirically. Changing trends have been noticed in the pattern of infection, possibly with increasing evidence of as causative organisms, previously reported to cause stromal keratitis. An elaborate review of the past and present literature on MKC is provided in this review article, along with gaps in knowledge, and future directions of research.

中文翻译：

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微孢子虫角结膜炎的过去、现在和前景——综述


眼微孢子虫病包括两种完全不同的疾病谱，即角膜结膜炎和基质角膜炎。在过去的二十年里，微孢子虫角结膜炎（MKC）的报道越来越多，这可能是由于人们认识的提高、诊断程序的简化以及对临床表现的更好的理解。其特征是存在凸起、粗糙、点状、多灶性、圆形至椭圆形、灰白色角膜上皮病变，通常在消退前演变成钱币状疤痕。结膜炎为非化脓性，轻度至中度，伴有混合性乳头滤泡反应。对传播方式和发病机制知之甚少。尽管缺乏炎症反应，但报告的不常见关联是内皮炎、角膜水肿、角膜缘炎、葡萄膜炎和上皮下浸润。对于MKC的管理尚未达成共识。它的范围从使用多种抗菌剂到简单的润滑剂。大多数疾病诊断不足或误诊，并根据经验使用局部类固醇或抗病毒药物作为腺病毒性角结膜炎进行治疗。人们已经注意到感染模式的变化趋势，可能是因为越来越多的证据表明先前报道的致病微生物会引起基质性角膜炎。这篇综述文章对 MKC 的过去和现在的文献进行了详细的回顾，并指出了知识的差距和未来的研究方向。