{
  "abstract": "A male in his 60s with post-vitrectomy glaucoma presented with right eye redness, watering and foreign body sensation for 1 week and was referred for corneal decompensation. At presentation, intraocular pressure in his right eye was 22 mm Hg on multiple anti-glaucoma medications including Rho-kinase (ROCK) inhibitors. As the patient was referred from another centre, detailed records of corneal status prior to initiation of ROCK inhibitors were not available. Slit lamp examination of the right eye showed multiple hexagonal-shaped epithelial bullae arranged in a reticular pattern throughout the cornea ( figure 1A). Anterior segment optical coherence tomography (AS-OCT) of the right eye revealed small distinct polygonal cystic spaces within the corneal epithelium, giving a honeycomb appearance (figure 1B), characteristic of Rho-kinase inhibitor toxicity. Despite advice to discontinue Rho-kinase inhibitors, the patient continued its use and subsequently developed corneal infiltrate in 10 days. Microbiology evaluation revealed Pseudomonas aeruginosa as the causative organism. Due to rapid progression including stromal thinning, consistent with corneal melt (figure 1C), necessitated urgent therapeutic penetrating keratoplasty (figure 1D) to control the infection and restore corneal integrity.",
  "authors": [
    {
      "affiliations": [
        "Glaucoma, LV Prasad Eye Institute, KAR campus, Hyderabad, Telangana, India"
      ],
      "name": "Sirisha Senthil"
    },
    {
      "affiliations": [
        "Glaucoma, LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India"
      ],
      "name": "Sivani Kodali"
    }
  ],
  "title": "Rho-kinase inhibitors predisposing to secondary keratitis",
  "uid": "10e8ca3b-b186-5134-adde-2b4c4932fa3c"
}