PURPOSE/METHODS: Eight years after eight-incision radial keratotomy, a corneal ulcer developed around the inferotemporal incision in an otherwise healthy 39 year-old man. There was no history of corneal trauma or contact lens wear. RESULTS/CONCLUSIONS: Both Fusarium and Acanthamoeba organisms were eventually isolated from the ulcer. A therapeutic keratoplasty was performed. Inferotemporal incisions may be predisposed to epithelial breakdown and infection many years after radial keratotomy.