Trauma to Transplant: Pediatric Pythium Keratitis Advancing to Anterior Staphyloma

Pythium keratitis, an aggressive vision-threatening infection that rarely affects children. We present the case of an 11-year-old boy who, three years after ocular trauma with a cow horn, experienced progressive corneal opacity and protrusion with vision loss in the right eye. He had a clinical diagnosis of Pythium keratitis, which progressed to anterior staphyloma after healing with scarring and ectasia. Histopathology confirmed the patient's healed Pythium keratitis sequelae after therapeutic penetrating keratoplasty. With better vision and cosmesis after surgery, the graft remained clear. This instance emphasises the importance of prompt keratoplasty in visual and cosmetic rehabilitation by highlighting an uncommon consequence of paediatric Pythium keratitis that progresses to anterior staphyloma.