title: [A case of intractable recurrent corneal erosion caused by Munchausen syndrome].
abstract: OBJECTIVE
  We report a case of intractable recurrent corneal erosion that was unresponsive to any medication, but was cured by psychiatric care after diagnosis of Munchausen syndrome.
  
  
  METHODS
  The patient, a 35-year-old female, who developed pain in her left eye in July, 20 XX, was diagnosed with epidemic keratoconjunctivitis at the hospital where she worked as a nurse. Despite medication, the eye condition gradually worsened. After undergoing examination at many medical institutions, she came to our hospital on October 6, 20 XX. Her left eye manifested superficial punctate keratitis, then exhibited recurring corneal erosion. The eye condition was intractable, total corneal epithelial defect ultimately occurring on December 30. Subsequently, a bottle of hydrochloric acid oxybuprocaine eyedrops was found under her pillow. We therefore suspected that the corneal erosion was due to self-inflicted injury. She consulted a psychiatrist, and was diagnosed with Munchausen syndrome. After about 2 months of therapy in which she was prevented from touching the eye(eye patch etc.), her eye condition improved.
  
  
  CONCLUSIONS
  This case was not diagnosed as Munchausen syndrome for 5 months. In cases of intractable corneal erosion, the possibility of self-injury should be considered.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectual University of Medicine, 465 Kajii-cho Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto 602-0841, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Tanifuji
authors.forename: Chie
authors.initials: C
authors.lastname: Sotozono
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Masanori
authors.initials: M
authors.lastname: Kunisawa
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kooguchi
authors.forename: Takanobu
authors.initials: T
authors.lastname: Yoshii
mesh_terms: D000328:Adult; D003315:Cornea / Q000473:pathology; D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D009110:Munchausen Syndrome / Q000150:complications*; D012008:Recurrence