Early Steroid Eye Drops for Preventing Corneal Infiltrates in Microsporidial Keratoconjunctivitis

INTERVENTION: Intervention1: Carboxymethylcellulose Sodium 0.5 percentage w/v with polyethylene glycol: Carboxymethylcellulose Sodium 0.5 percentage w/v with polyethylene glycol will be administered topically to the study eye as required. Control Intervention1: Carboxymethylcellulose Sodium 0.5 percentage w/v with lotepred 0.5 percentage: Carboxymethylcellulose Sodium 0.5 percentage w/v will be administered topically to the study eye as required. Loteprednol 0.5 percentage ophthalmic suspension will be administered topically and tapered weekly Control Intervention2: Not Applicable: Not Applicable CONDITION: Health Condition 1: H162‐ Keratoconjunctivitis PRIMARY OUTCOME: Incidence of immune mediated ocular inflammation defined as the occurrence of any of the following ; ; Persistent or clinically significant SEIs ; ; Immune stromal keratitis ; ; Anterior uveitisTimepoint: 84 days SECONDARY OUTCOME: 1 Time to epithelial healing and complete resolution ; ; 2 Requirement for rescue steroid therapy ; ; 3 Steroid related adverse events including raised IOP delayed epithelial healing and secondary infection ; ; 4 Visual acuity in both treatment arms ; ; 5 Proportion of intestinal microsporidiosis among cases with microsporidial keratitisTimepoint: 84 days INCLUSION CRITERIA: 1 Acute onset of symptoms preferably within 7 days some studies may allow up to 10 days 2 Clinical features suggestive of MKC multifocal coarse raised epithelial lesions with conjunctivitis 3 Microbiologically confirmed microsporidial spores on corneal scraping KOH plus CFW and or Gram stain 4 Willingness to provide informed consent and comply with follow up