title: Late-onset peripheral ulcerative sclerokeratitis associated with alkali chemical burn.
abstract: OBJECTIVE
  To report delayed-onset peripheral ulcerative keratitis (PUK) following alkali injury.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  setting: Single institution (Cornea and External Disease Service, Moorfields Eye Hospital). participants: Six eyes of 5 patients with PUK and associated anterior scleritis that had a history of ocular alkali injury. observationprocedure: Patients were identified among PUK patients seen at Moorfields Eye Hospital over a 20-year period. main outcomes measures: Patients' demographics, clinical features, treatment, and outcomes.
  
  
  RESULTS
  Recurrent PUK with scleritis following alkali burns occurred in 5 male patients/6 eyes (median age: 22 years, range 18-38) several years after the chemical trauma (average: 6.4 years; range 3-12). Management of PUK in these patients was similar to PUK arising from other etiologies.
  
  
  CONCLUSIONS
  In this series of patients there was no evidence of an underlying vasculitic cause for the PUK. A localized autoimmune response may, however, be involved in the pathogenesis of these cases, as seen in an animal model of chemical injury or in late mustard gas keratitis. We hope that this case series will bring this newly described condition to the attention of ophthalmologists and that this may assist in their treatment, which, in this series, required systemic immunosuppressive therapy.
authors.affiliation: Cornea and External Diseases Service, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom. Electronic address: alfonsoiovieno@hotmail.com.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Iovieno
authors.affiliation: James Cook University Hospital, Middlesbrough, United Kingdom.
authors.forename: Seema
authors.initials: S
authors.lastname: Anand
authors.affiliation: Cornea and External Diseases Service, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom; National Institute of Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom.
authors.forename: John K
authors.initials: JK
authors.lastname: Dart
mesh_terms: D000293:Adolescent; D000328:Adult; D000468:Alkalies / Q000009:adverse effects*; D002057:Burns, Chemical / Q000209:etiology* / Q000628:therapy; D016039:Corneal Transplantation; D003320:Corneal Ulcer / Q000209:etiology* / Q000628:therapy; D005126:Eye Burns / Q000139:chemically induced*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents; D008297:Male; D012189:Retrospective Studies; D015423:Scleritis / Q000209:etiology* / Q000628:therapy; D013997:Time Factors; D055815:Young Adult
chemical_list: D000468:Alkalies; D005938:Glucocorticoids; D007166:Immunosuppressive Agents