Unilateral Corneal Ulcer in a 2-Month-Old Infant Without Identifiable Predisposing Factors: A Case Report

Background/Objectives: To describe the presentation, diagnostic evaluation, management, and clinical outcome of unilateral corneal ulcer in an otherwise healthy infant without identifiable predisposing factors. Methods: We report a case of a 2-month-old infant who presented with a visible white corneal lesion. Initial examination revealed a 2 × 1 mm fluorescein-positive corneal ulcer with a surrounding stromal infiltrate. There was mild conjunctival injection without ocular discharge. The anterior chamber was deep, without cells or flare. Corneal scraping was deferred because specimen collection would have required sedation or general anesthesia. Consequently, the microbial etiology remained unconfirmed, and empirical antimicrobial treatment was initiated. Results: The patient was treated with topical azithromycin, tobramycin, moxifloxacin, and aciclovir, as well as liposomal ozonized oil eye drops. During empirical treatment and close clinical monitoring, the corneal epithelial defect resolved within seven days, and the surrounding stromal infiltrate progressively decreased in size and opacity. At the one-month follow-up, a small residual stromal scar remained outside the visual axis. Conclusions: This case illustrates the diagnostic and therapeutic challenges of managing corneal ulcer in early infancy when microbiological confirmation is unavailable. The favorable clinical course observed during empirical treatment and close monitoring does not establish an infectious etiology or demonstrate a causal effect of antimicrobial therapy.