To report a case of infectious crystalline keratopathy following corneal cross linking which was resistant to conventional trearments.

A 25 year old gentleman came to our clinic because of ocular pain and blurred vision in his right eye. He had undergone corneal cross linking due to keratoconus 3 weeks prior to initiation of symptoms. Initial Visual acuity was 2 meter count finger. Slit-lamp examination revealed central corneal infiltration with branching margin. No epithelial defect was detected. Smear and culture revealed staphylococcus areus. We started fortified vancomycin and the consequent response to this treatment was partial and unsatisfactory. Superficial keratectomy was done according to raised corneal infiltration. Intrastromal vancomycin was injected for patient and a dramatic response was achieved.

The patient’s best corrected visual acuity was 20/40 2 weeks after injection. Corneal infiltration and other signs and symptoms resolved.

ICK is a slowly progressive infection with poor response to antimicrobial treatment.1 O In our case we chose intrastromal injection of vancomycin, the dramatic response was achieved. The patient’s best corrected visual acuity was 20/40 2 weeks after injection. Corneal infiltration and other signs and symptoms resolved,and minimal scarring was left.