Acute bilateral diffuse corneal opacity in a child.
OBJECTIVE
To report a case of acute bilateral corneal opacity related to bacterial blepharoconjunctivitis.


METHODS
Interventional case report. An 18-month-old boy had bilateral red eyes with discharge and periorbital eczema. Bilateral corneal opacity suddenly developed 1 week later.


RESULTS
All clinical assessments and laboratory evaluations of viral infection and autoimmune profiles were negative except for growth of coagulase-negative staphylococcus and propionibacterium acnes from conjunctival discharge. After systemic and topical antibiotic treatment, the opacity and inflammation of both eyes decreased. The left cornea became clear, but the right eye had a sequela of corneal opacity with stromal neovascularization and conjunctival scarring. Penetrating keratoplasty was performed in the right eye 6 months later. Histology at that time showed neovascularization in the deep stroma with perivascular mononuclear cell infiltration and decreased endothelial cells.


CONCLUSIONS
Acute bilateral corneal opacity is rare but may occur in children with bacterial blepharokeratoconjunctivitis. Ocular surface inflammation may be induced by bacterial toxin reaction. Combined use of antibiotics and steroids may save the vision in such patients.
Wang
Tsung-Jen
TJ
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Hsiao
Cheng-Hsiang
CH
Hu
Fung-Rong
FR
Wang
I-Jong
IJ
Hou
Yu-Chih
YC
D000208:Acute Disease; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001762:Blepharitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D003231:Conjunctivitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015715:Corneal Edema / Q000175:diagnosis / Q000209:etiology; D003318:Corneal Opacity / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D011425:Propionibacterium acnes / Q000302:isolation & purification*; D013407:Sulbactam / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000667:Ampicillin; D013407:Sulbactam