Peripheral ulcerative keratitis in a child

Leung, Andrea K.; Mireskandari, Kamiar; Ali, Asim

doi:10.1016/j.jaapos.2011.06.009

Cited by 9 publications

(5 citation statements)

References 7 publications

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“…Peripheral ulcerative keratitis (PUK) was also entertained as a diagnosis, due to the presence of a peripheral corneal lesion associated with redness, irritation and photophobia. It is extremely rare in children, but classically manifests as peripheral corneal infiltrates that lead to epithelial breakdown and frank ulceration [4] [5]. A slit-lamp image of a true peripheral ulcerative keratitis (Figure 3(a)) showing limbal ulceration, conjunctival injection and pannus, is shown for comparison to our patient's corneal foreign body slit-lamp image (Figure 1(a)).…”

Section: Discussionmentioning

confidence: 77%

Phlyctenulosis-Like Presentation Secondary to Embedded Corneal Foreign Body

Muthappan¹,

Smedley²,

Fenzl³

et al. 2014

OJOph

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Case Presentation: A nine-year-old boy presented to the general ophthalmologist with a several weeks history of redness, photophobia and intermittent foreign body sensation in the right eye. A pigmented lesion with anterior chamber inflammation was noted on examination. B-scan ultrasound was performed and revealed no foreign body. The patient was diagnosed with anterior uveitis, which did not completely respond to treatment. The differential diagnosis was expanded to include peripheral ulcerative keratitis, phlyctenulosis, pigmented neoplasm, and corneal foreign body. Upon referral to a cornea specialist, an exam under anesthesia revealed a large foreign body consistent with a rock fragment in the peripheral cornea, which was subsequently removed without complication. Conclusion: This case highlights an atypical presentation of foreign body as well as a differential diagnosis of pigmented peripheral corneal lesions. Foreign bodies represent the most common cause of urgent ophthalmic evaluation. When evaluating lesions of the cornea, it is imperative to keep an extensive differential diagnosis, giving the potential for severe and rapid development of visually threatening complications.

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Section: Discussionmentioning

confidence: 77%

Phlyctenulosis-Like Presentation Secondary to Embedded Corneal Foreign Body

Muthappan¹,

Smedley²,

Fenzl³

et al. 2014

OJOph

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“…[1][2][3][4][14][15][16][17][18][19] Failure to diagnose and treat a perforation early can lead to further corneal damage, cataract formation, secondary glaucoma due to formation of peripheral anterior synechiae, and loss of the eye, especially if the inflammatory response is marked. 15 Further, a delay in the management could result in amblyopia of the affected eye, especially when the central cornea is involved.…”

Section: Discussionmentioning

confidence: 99%

“…Non-traumatic corneal perforation in children is rare, but may be seen in neurotrophic ulcers, 1 infectious keratitis, 2 peripheral ulcerative keratitis, [3][4][5] ocular surface diseases such as blepharokeratoconjunctivitis (BKC) with or without rosacea, 6,7 and chemical burns. 8 Systemic conditions including juvenile rheumatoid arthritis 9,10 and Stevens Johnson syndrome 11,12 can rarely cause corneal perforation, while in developing countries, vitamin A deficiency is a common cause of non-infectious corneal melt in children.…”

Section: Introductionmentioning

confidence: 99%

Management of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature

Medsinge

Gajdošová

Moore

et al. 2016

Eye

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Purpose To assess the outcome of early therapeutic penetrating keratoplasty (PKP) for corneal melt leading to perforation in children.Methods Case notes of all the consecutive patients presenting with acute corneal perforation that underwent urgent therapeutic PKP between 2000 and 2010 to the practice of one of the authors, both NHS at Great Ormond Street Hospital for Children and private, were retrospectively reviewed. Onset of perforation, underlying cause, medical and surgical treatment, pre-and post-operative visual acuity, graft clarity, length of followup, and post-operative complications were recorded. Results Four eyes of four consecutive patients (mean age of 9.5 years and median 8.5 years, range 4-17 years) were treated for acquired acute onset corneal perforations. There were three females and one male.

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“…1 Peripheral ulcerative keratitis is a destructive process that involves inflammation of the perilimbal cornea 1 and overlying epithelial defects. 2 The diseases commonly involved in this region are Mooren ulcers, autoimmunity against the cornea itself, 1 or manifestations of systemic disease, 3 especially rheumatoid arthritis and vasculitides. 4 When the peripheral corneal ulcer is accompanied by necrotizing scleritis, perforation and consequently loss of vision can occur, which confirms the severity of this eye disease.…”

Section: Introductionmentioning

confidence: 99%

Infliximab is effective in difficult-to-control peripheral ulcerative keratitis. A report of three cases

Zandavalli¹,

Castro²,

Mazzucco³

et al. 2015

Revista Brasileira de Reumatologia (English Edition)

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r e v b r a s r e u m a t o l . 2 0 1 5;5 5(3):310-312 w w w . r e u m a t o l o g i a . c o m . b r a b s t r a c t Peripheral ulcerative keratitis is caused by an inflammatory and destructive process of the perilimbal peripheral cornea. This inflammation is due to immune complex deposition in this region of the cornea and in adjacent vessels. It can be idiopathic, or a manifestation of systemic disease such as rheumatoid arthritis, vasculitis of small vessels associated with ANCA, relapsing polychondritis, systemic lupus erythematosus and Crohn's disease. Its treatment includes the use of high-dose corticosteroids and, in some cases, the concomitant use of immunosuppressants such as methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide or cyclosporine. The use of immunobiological agents can be a strategy in cases of difficult control. The authors describe the treatment of three patients who, after failure with the use of corticosteroids or immunosuppressants, showed good response after the use of infliximab. Infliximabe é eficaz em ceratite ulcerada periférica de difícil controle. Um relato de três casos Palavras-chave: Ceratite Úlcera de córnea Anticorpo monoclonal r e s u m o Ceratite ulcerada periférica é causada por um processo inflamatório e destrutivo da córnea periférica perilimbar. Essa inflamação se deve à deposição de imunocomplexos nessa região da córnea e nos vasos adjacentes a ela. Pode ser idiopática ou uma manifestação de doença sistêmica como artrite reumatoide, vasculites de pequenos vasos associadas ao ANCA, à policondrite recidivante, ao lúpus eritematoso sistêmico e à doença de Crohn. O tratamento inclui o uso de corticoide em dose alta e em alguns casos o uso concomitante de imunossupressores, como metotrexate, azatioprina, micofenolato mofetil, ciclofosfamida ou ciclosporina. O uso de agentes imunobiológicos pode ser uma estratégia nos casos de

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Peripheral ulcerative keratitis in a child

Cited by 9 publications

References 7 publications

Phlyctenulosis-Like Presentation Secondary to Embedded Corneal Foreign Body

Phlyctenulosis-Like Presentation Secondary to Embedded Corneal Foreign Body

Management of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature

Infliximab is effective in difficult-to-control peripheral ulcerative keratitis. A report of three cases

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