13th February 2025

A 33-year-old lady presents after treatment with topical aciclovir for suspected HSV keratitis.

A 33-year-old lady presents after treatment with topical aciclovir for suspected HSV keratitis. She has had left eye pain that has been gradually worsening over the last 3 weeks. She feels that the pain has not improved with treatment and is becoming unbearable. She has a longstanding history of contact lens wear and has a prescription for daily wear, reusable lenses. She tells you that she had been attending her local health club to use the jacuzzi and may have forgotten to take her lenses out a couple of times in the last month while using it.

On examination, you note small, irregular grey-coloured infiltrates on the cornea, and her pain is out of proportion to clinical findings.

Which of the following is the most likely responsible pathogen?

Select the SINGLE most appropriate option from the list below. Select ONE option only.