A 15-year-old myopic female contact lens wearer developed severe central corneal keratitis in the left eye caused by Pseudomonas aeruginosa. A rapid diagnosis and treatment led to a satisfactory response, although a gray central corneal scar, hyperopia, and visual loss remained. No surgery was required after the infection resolved, and the patient was assessed annually. Sixty-four months later, the cornea was almost totally transparent and she had a visual acuity of 20/20. The results of the topographical examination were similar to those after a refractive ablative procedure. Satisfactory refractive outcome after severe Pseudomonas aeruginosa keratitis may occur in extraordinary cases.