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With improved understanding of these varied ocular and systemic factors contributing to the refractory nature of the microbes, role of biofilm formation and recent research on improving the bioavailability of drugs along with the development of alternative therapies have helped provide the required multidimensional approach to effectively diagnose and manage cases of refractory corneal ulcers and prevent corneal perforations or further dissemination of disease. In this review, we explore the current literature and future directions of the diagnosis and treatment of refractory keratitis.<\/jats:p>","DOI":"10.4103\/ijo.ijo_2273_21","type":"journal-article","created":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T06:53:23Z","timestamp":1652252003000},"page":"1475-1490","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Update on diagnosis and management of refractory corneal infections"],"prefix":"10.4103","volume":"70","author":[{"given":"Shweta","family":"Agarwal","sequence":"first","affiliation":[{"name":"Dr. G. Sitalakshmi Memorial Clinic for Ocular Surface Disorders, C. J. Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanveer A","family":"Khan","sequence":"additional","affiliation":[{"name":"Cornea, Lens and Refractive Surgery Services, Dr. R. P. 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