Corneal infiltration after recurrent corneal epithelial erosion.
OBJECTIVE
To describe the clinical features of patients with a history of recurrent corneal epithelial erosion who develop acute corneal infiltration.


METHODS
The records were reviewed of patients who had previously been examined and treated for recurrent corneal epithelial erosion and who presented again with signs suggestive of a microbial keratitis.


RESULTS
11 patients were described; one patient presented with similar signs on two occasions. There was typically a paracentral epithelial defect > 2 mm in diameter with an associated stromal infiltrate and an intense anterior uveitis. Three patients had a hypopyon, and four developed a subepithelial ring infiltrate. Samples were taken for microscopy and bacterial culture, with a positive isolate from two of 12 episodes (16%). Treatment with topical antibiotics and topical corticosteroid resulted in rapid re-epithelialisation and a reduction of inflammation. There was good visual outcome for all eyes, with a recurrence or symptoms of epithelial erosion in only one eye after a mean follow up period of 18 months.


CONCLUSIONS
Corneal infiltrates are an uncommon complication of recurrent corneal epithelial erosion. Despite the intensity of the infiltration the majority are culture negative using established techniques. There is typically rapid resolution and a good visual outcome, with a tendency for the episode to mark the end of further symptoms of epithelial erosion.
Ionides
A C
AC
Moorfields Eye Hospital, London.
Tuft
S J
SJ
Ferguson
V M
VM
Matheson
M M
MM
Hykin
P G
PG
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003316:Corneal Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D003319:Corneal Stroma / Q000473:pathology; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014605:Uveitis / Q000188:drug therapy / Q000382:microbiology
D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents