Genotypic analysis revealed key resistance mechanisms, including antibiotic efflux, inactivation, and target alteration, as well as several structural and secreted virulence factors. Whilst MDR and extensively drug-resistant (XDR) strains were identified among the keratitis P. aeruginosa isolates, most isolates in this study were susceptible to gentamicin. These findings offer valuable insights for developing targeted therapeutic strategies that, when used in combination with antibiotics, may improve treatment outcomes and help mitigate the emergence of resistance.