To report the clinical picture and management of 4 cases of presumed paederus-induced keratitis.The clinical characteristics of the anterior segment and periocular area were presented. The outcomes and healing course of the corneal lesions were recorded.Each patient sustained an accidental eye injury from a beetle while riding a motorcycle. Three cases were complicated by periocular dermatitis. All patients had diffuse punctate epithelial erosions or large epithelial defects on the unilateral cornea. Prolonged corneal epithelialization was noted after lubrication with artificial tears and wearing a contact lens. Reepithelialization was promoted after topical supplementation with 20% autologous serum. All 4 patients had good visual outcomes. Two patients healed with a faint corneal scar.Paederus-induced keratitis could result in extensive involvement of the corneal surface. Keratitis with a large epithelial defect mimicking the corrosive lesion of a chemical burn requires aggressive therapy, such as autologous serum combined with a bandage contact lens. Avoiding contact with the crushed body of the beetle while rubbing the eye is mandatory to prevent this type of keratitis.