Spontaneous corneal perforation complicating ocular rosacea: Case report

Abstract

Introduction Ocular rosacea is a multifactorial disease. Its pathophysiology remains unclear. The ocular manifestations of rosacea are not specific and can range from simple blepharoconjunctivitis to sight-threatening such as corneal perforation. Case report We report the case of a 10-year-old child who presented with a red painful right eye. Based on the clinical findings, we concluded that she had a corneal perforation on ocular rosacea. She benefited from an ipsilateral lamellar autokeratoplasty by lamellar autograft. The evolution was marked by a good healing and a good visual recovery despite a corneal scar. Discussion Ocular rosacea is a multifactorial disease, with an unclear physiopathology. Corneal involvement remains the least common, but the most challenging since serious complications can occur. Corneal perforation is the most severe. Several techniques have been reported and used in the management of corneal perforations such as conjunctival flap, amniotic membrane grafting, and the use of a corneal patch. The later, corneal autografting, remains a simple and effective technique with satisfactory anatomical results. Conclusion Ocular rosacea is a pathology that is still poorly understood and of delayed diagnosis. It can lead to serious vision-threatening complications such as corneal perforation. The corneal patch is a simple, effective and efficient technique that has given good results in our case.

Efficacy of treatments for rosacea in the pediatric population: A systematic review

“…Eleven patients were treated with azithromycin in conjunction with other medications including corticosteroids, cyclosporine or doxycycline. Nine of these patients were able to achieve complete remission within 6.5 months 18,19,21,22 . The treatments lengths varied, ranging between 3 and 10 months.…”

“…We identified 10 articles studying a total of 39 patients. [14][15][16][17][18][19][20][21][22][23] Thirty-six patients (36/39, 92%) were diagnosed with ocular rosacea and treated with azithromycin ophthalmic solution (19 patients) or systemically (17 patients), with the most common doses of 1.5% or 5-10 mg/kg/day, respectively. Twenty-six of these ocular rosacea cases were treated with azithromycin as a monotherapy, with 17 patients, treated with 1.5% azithromycin ophthalmic solution, achieving complete remission within 10 months.…”

“…Nine of these patients were able to achieve complete remission within 6.5 months. 18,19,21,22 The treatments lengths varied, ranging between 3 and 10 months.…”

“…Five articles reporting on 5 patients were identified. 21,44,66,75,76 Two patients (2/5, 40%) were diagnosed with Surgery was used to resolve the lesions, with 1 case achieving complete remission. 66,75 One patient (1/5, 20%) was diagnosed with erythrotelangiectatic rosacea, with laser treatment being used.…”

“…Lamellar autokeratoplasty was performed, resulting in partial remission. 21 One patient (1/5, 20%) was diagnosed with rhinophyma. Electrosurgery and 4 sessions of pulse-dye laser were performed, resulting in partial remission.…”