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Background Ting et al. recently reported increasing coagulase-negative staphylococci and Acanthamoeba keratitis in North East England, whilst Tan et al. demonstrated increasing Moraxella in Manchester. We performed a 10-year retrospective analysis at Southampton Eye Unit to determine whether similar trends exist in Southern England.Methods All culture-positive corneal scrapes from Southampton Eye Unit (January 2014 - December 2023) were reviewed. Organisms were classified into Gram-positive, Gram-negative, fungi, and Acanthamoeba. Data were divided into two periods (2014 - 2018 and 2019 - 2023) for comparison. Chi-square tests assessed temporal changes; one-way ANOVA and chi-square tests examined demographic associations.Results Of 798 corneal scrapes, 512 (64.2%) were culture-positive. Mean age was 53.2 (SD 20.7) years; 251 (49.0%) were female. Gram-positive organisms predominated (310; 60.5%), followed by Gram-negative (152; 29.7%), fungi (29; 5.7%), and Acanthamoeba (21; 4.1%). Notably, significant increases were observed in Staphylococcus aureus (14.6% to 27.4%; p=0.006) and Serratia marcescens (1.4% to 11.0%; p=0.018), with concurrent decreases in coagulase-negative staphylococci (64.0% to 49.3%; p=0.009) and Acanthamoeba (6.4% to 1.6%; p=0.007). Acanthamoeba keratitis affected a significantly younger population (mean 39.7 years; p=0.014). Fungal keratitis showed female predominance (75.9%; p=0.020).Conclusion Southampton demonstrates a marked rise in S. aureus and Serratia keratitis. This pattern may indicate increasing ocular surface vulnerability. Acanthamoeba keratitis predominantly affects a younger population, and appears to be decreasing; this may reflect change in exposure risk and a shift in diagnostic modalities. These findings highlight important geographic and temporal variation in UK microbial keratitis epidemiology.