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PAP is characterized by a progressive constellation of eyelid, periorbital, and conjunctival signs that contribute to cosmetic and functional challenges for patients and clinicians. This constellation of findings can produce an asymmetric appearance, symptomatic discomfort, and ocular surface changes to patients. In our case, these changes resulted in previously unreported sight\u2010threatening sequelae from bacterial keratitis. The authors report a case of PAP\u2010induced lagophthalmos and secondary microbial keratitis that necessitated a corneal graft. Reversal of these findings occurred on prostaglandin cessation with dramatic reversal of findings within 8 weeks.<\/jats:p>","DOI":"10.1155\/crop\/5635118","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T08:35:49Z","timestamp":1759912549000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Severe Microbial Keratitis Secondary to Prostaglandin\u2010Associated Periorbitopathy"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3725-236X","authenticated-orcid":false,"given":"Matthew H.","family":"McCartney","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7285-9928","authenticated-orcid":false,"given":"Fady K.","family":"Sammouh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3382-9854","authenticated-orcid":false,"given":"Jessica Y.","family":"Tong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Chehade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinesh","family":"Selva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"e_1_2_9_1_2","article-title":"PAP: New Concerns for Prostaglandin Use","volume":"19","author":"Berke S. 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