Abstract:  Corneal diseases are an important leading cause of blindness in China, with infectious keratitis being a major contributor. The evolving lifestyle patterns, emerging infectious diseases, and shifts in clinical practices have heightened the risk of misdiagnosis for atypical corneal infections, posing severe threats to visual prognosis. For ocular surface infections, special attention should be paid to lifestyle-associated cases, including microsporidial keratoconjunctivitis (MKC) linked to pet exposure. Emerging pathogens (e.g., monkeypox virus, SARS-CoV-2) and classical diseases (e.g., tuberculosis, syphilis) can also involve the cornea, necessitating vigilance for ocular transmissibility. The rising use of contact lenses-particularly orthokeratology lenses-has increased the risk of acanthamoeba keratitis, while post-refractive surgery non-tuberculous mycobacterial (NTM) interface infections require close monitoring. Diagnosis should integrate confocal microscopy, mass spectrometry, and metagenomic next-generation sequencing (mNGS). While mNGS enables comprehensive detection of fastidious pathogens, clinical correlation is critical for data interpretation. Therapeutic strategies emphasize multidisciplinary collaboration, adopting innovations such as corneal cross-linking (CXL), intrastromal drug delivery, and advanced systems (e.g., nanocarriers, sustained-release implants). Novel agents like polymyxin B derivatives are under development for drug-resistant strains. Future efforts should focus on clinician-laboratory synergy, multimodal diagnostic systems, and AI-assisted analysis to achieve precision management under the "early diagnosis, rapid treatment, blindness prevention" framework.

Key words: Special corneal infection/diagnosis, Special corneal infection/treatment