This review article provides an up-to-date summary of current challenges in research and management of bacterial keratitis. The authors highlight that there is no current agreement on the criteria that should define bacterial keratitis; the role of investigation is unclear, in particular how this affects outcomes. The authors suggest a diagnostic rule to establish how to interpret isolates whether identified from culture or metagenomics. They also explored new technologies for investigation to enable personalisation of treatment and non-antibiotic therapies are being introduced encompassing phage and anti-virulence compounds.