pterygium is an ocular lesion that is usually benign and is frequent in sunny countries . the intervention consists of the excision of the pterygium followed by the closing of the exeresis location . excimer laser , beta irradiation , and antimitotic molecules can be associated with this surgery.1 infectious complications are rare . the authors describe a case of keratomycosis that appeared after the exeresis of a pterygium . a 48-year - old patient had been referred for a red right eye , associated with an abscess of the cornea along the ablation zone of the pterygium . surgery had been performed a month beforehand and had involved the exeresis of a grade 2 recurring nasal pterygium . the patient did not leave her house , except between days 8 and 15 post surgery where she spent some time outside in her garden . on day 25 post surgery , the increase of the secretions as well as the appearance of a white area on the surgical site led the patient to consult her ophthalmologist . the symptoms persisted and the patient was referred to the service 4 weeks post surgery . there was a 6 mm high and 4 mm wide abscess of the cornea around the ablation site of the pterygium . ulceration with raised edges of about 3 mm was at the center of the abscess . the main abscess , along with several microabscesses , was located in the temporal region . a discreet proteic tyndall was noted , as well as folds of the descemet s membrane of the nasal hemicornea . there was no hypopyon or posterior synechia and no ocular hypertonia ( figure 1 ) . a clinical aspect evoking a fungal keratitis and the revealing of several septate filaments on direct examination led the authors to establish a treatment involving ticarcillin ( 7 mg / ml ) , gentamicin ( 15 mg / ml ) , vancomycin ( 50 mg / ml ) , and amphotericin b ( 0.25% ) . the antifungal treatment was prescribed as follows : one instillation every 5 minutes for 1 hour , then every hour for 3 days , then eight times a day for 2 months , and then , finally , six times a day for 1 month . reinforced collyriums were replaced on day 8 by ciprofloxacin ( six times per day ) and this was maintained for 15 days . cycloplegic collyrium was prescribed for 4 weeks and artificial tears for 12 weeks . on day 10 , a fusarium dimerum was isolated on the sabouraud agar . after 15 days of treatment , the evolution was favorable and the size of both the ulceration and the abscess had progressively diminished . the abscess was replaced with a whitish stromal scar with a big vertical axis and a diameter of about 5 mm ( figure 2 ) . there was no more ulceration , but the cornea appeared slimmer within the ablation zone of the head of the pterygium . surgery of the pterygium is usually considered as having a low rate of complications of infectious origin . nevertheless , infectious complications can appear a few days or even a few years post surgery . it essentially concerns bacterial agents ; pseudomonas aeruginosa is the germ that is usually the cause . other infections by fungus are even more rare ; in a study by lin et al2 of 30 eyes infected after pterygium surgery , only one case of fungal origin ( cephalosporium ) was included . other than cases reported by moriarty et al3 ( complications appeared 15 years after radiotherapy ) and peponis et al4 ( complications appeared 3 weeks post surgery and following use of mitomycin c ) , to the authors knowledge , this is the first case of a keratomycosis due to f. dimerum reported that complicated the exeresis of a pterygium without the use of an adjuvant anti - healing treatment . in this case , the evolution of the first observation was good , contrary to the second observation when the extension of the infection beyond the ocular structures led to the realization of enucleation . like pterygium , keratomycosis is more frequent in tropical countries.5 the breaking of the corneal epithelium following surgery encouraged the appearance of a mycosis ; the gardening undertaken by the patient is the obvious source of a vegetal foreign body . all instances of potential risk related to foreign bodies of any nature , including vegetal , must be avoided until complete re - epithelialization of the corneal ablation site of the pterygium . although pterygium surgery is a commonly performed procedure , ophthalmologists should be aware of potential infectious complications that can have dramatic outcomes .