Abstract
A 61 ‐year‐old female patient wearing rigid gas permeable (RGP) lenses on a daily basis presented with considerable pain and hyperaemia in the right eye. Biomicroscopic examination revealed marked stromal and endothelial oedema with folds in Descemet's membrane, and a focal infiltrate near the inferior limbus. The infiltrate was diagnosed as sterile on the basis of an intact overlying epithelium, lack of discharge and anterior chamber reaction, and the peripheral location. Considering the size and superficial nature of the infiltrate, the pain and corneal oedema were disproportionately severe. Differential diagnosis and management of sterile infiltrative keratitis are discussed using this case as an example.