Wegener's granulomatosis is a rare necrotising vasculitis not easily diagnosed due to the obscurity of its diverse clinical features. Despite its comparatively low incidence, the unusual ophthalmic manifestations seen in this disease warrant extra caution from attending rheumatologists. In this case, bilateral peripheral ulcerative keratitis preceded any systemic symptoms. Timely recognition of the significance of this ophthalmic complaint and prompt ophthalmological consultation can help achieve early diagnosis and treatment of this potentially fatal rheumatological disease.