Keratitis presents a sight-threatening condition that requires urgent diagnosis, investigation and management.  There needs to be a high index of suspicion for infectious causes such as bacterial, fungal, viral or acanthamoebal, with scraping for identification and intensive treatment with the appropriate antimicrobials.  Inflammatory causes for keratitis can present similarly to infection, however the management is immunosuppression with topical and/or oral agents.  There needs to be strategies for follow-up and alternative management options in case of sub-optimal response to treatment.  Significant recovery of the corneal opacity can occur over a 12 month period, with visual recovery possible without the need for transplantation.