WHEN INFECTION MEETS INFLAMMATION: DIAGNOSTIC PITFALL AND STRATEGIC CORTICOSTEROID TIMING IN A CORNEAL ABSCESS COMPLICATED BY CATARRHAL INFILTRATE IN OCULAR ROSACEA

Background: Bacterial corneal abscess is a vision threatening emergency requiring prompt management. Ocular rosacea is a chronic inflammatory condition often associated with meibomian gland dysfunction and sterile peripheral corneal infiltrates. The coexistence of infectious and inflammatory mechanisms represents a major therapeutic challenge, particularly regarding the timing of corticosteroid introduction.This case aims to highlight the diagnostic challenge and therapeutic strategy in such dual-mechanism conditions. Case presentation: We report the case of a 31-year-old patient pres enting with a central corneal abscess associated with ocular rosacea. Initial management with intensive topical antibiotics led to clinical improvement. However, a secondary peripheral infiltrate with corneal neovascularization appeared despite infection control. Careful examination of eyelid margins revealed underlying rosacea with severe blepharitis and meibomian gland dysfunction, supporting the diagnosis of a sterile catarrhal infiltrate.