**6. Differential diagnosis**

The clinical presentation of infectious keratitis is not usually easy to identify, the main differential diagnoses are the following:


#### **Figure 2.**

*Slit-lamp microscopy of the same patient's right eye showing corneal surface with fluorescein staining, showing the central epithelial defect.*

treatment during the early postoperative phase (between 10 and 20 days). Cases have been reported even up to 10 years after surgery [31–33]. Measuring IOP increase can be difficult using Goldmann tonometry in the center of the cornea, so it is best doing it in the peripheral part of the cornea. This condition is managed using topical medications to reduce eye pressure. Contrary to most other complications, use of corticosteroids is not recommended; therefore, it is important to have an accurate differential diagnosis [34].

• Epithelial growth at the interface. It is caused by the proliferation of epithelial cells at the interface. It is whitish in appearance, painless, without inflammatory reaction, confined to the edge of the flap, and of later presentation. However, it can generate irregular astigmatism and decreased vision if the visual axis is compromised (**Figures 1** and **2**).
