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PURPOSE To describe bilateral microsporidial keratoconjunctivitis in healthy individuals with long-term follow-up. METHODS Six cases of smear-positive bilateral microsporidial keratoconjunctivitis were diagnosed and followed up during the study period August 2017 to January 2019. Associated risk factors, clinical features, coexistence with adenovirus, clinical course, and recurrence were studied. RESULTS The mean age was 36.6 years (range 10-65 years). The mean duration of symptoms was 13.6 days (range 7-60 days). Predisposing risk factors were present in 4