Successful treatment for a corneal ulcer requires proper diagnosis and antibiotic selection. The management should be guided by the severity of the clinical presentation, the ophthalmologist's confidence in making the proper diagnosis of bacterial keratitis, and the level of trust in the antibiotic agents chosen for the causative organisms. Universal standards include pretreatment cultures and dual broad-spectrum fortified antibiotics. Recent changes in practice suggest that empirical monotherapy treatment with a fluoroquinolone antibiotic may be appropriate for certain cases of bacterial keratitis. This article reviews the various diagnostic methods and treatment options currently practiced in the ophthalmic community.