Ocular thermal and chemical injuries are a true ocular emergency and require immediate and intensive evaluation and treatment. The sequelae of an ocular burn can be severe and particularly challenging to manage. Improvements in the understanding of the pathophysiology of a radiant energy or chemical injury as well as advancements in ocular surface reconstruction have provided hope for patients in whom would otherwise have a dismal visual prognosis.

This case report indicates that fungal keratitis may occur from donor-to-host transmission after DSAEK. The location of the infected tissue poses diagnostic and therapeutic challenges for the surgeon.