title: Rare case of bilateral perforated corneal ulcer due to gonococcal infection, managed with temporary periosteal graft.
abstract: A 17-year-old female patient was referred to Kirana Ophthalmology Unit, Cipto Mangunkusumo Hospital, with a 10-day history of redness and swelling of the eyes, and inability to open them. Other symptoms included pain, blurred vision and excessive yellowish-white discharge from both eyes. There was a history of multiple sexual partners. The patient was assessed with bilateral perforated corneal ulcer due to gonococcal infection, based on the findings of intracellular and extracellular Gram-negative diplococci found on the Gram staining examination. The cornea in both eyes showed perforation with iris prolapse inferiorly. The perforations were treated with temporary periosteal grafts. The grafts remained in place after the surgery. Final uncorrected visual acuity was 6/20 in the right eye and 6/24 in the left eye, a few months after surgery.
authors.affiliation: Department of Ophthalmology, Cipto Mangunkusumo Kirana Hospital, Jakarta, Indonesia.
authors.forename: Nuriadara
authors.initials: N
authors.lastname: Samira
authors.affiliation: Department of Ophthalmology, Cipto Mangunkusumo Kirana Hospital, Jakarta, Indonesia.
authors.forename: Anna Puspitasari
authors.initials: AP
authors.lastname: Bani
authors.affiliation: Department of Ophthalmology, Cipto Mangunkusumo Kirana Hospital, Jakarta, Indonesia.
authors.forename: Made
authors.initials: M
authors.lastname: Susiyanti
mesh_terms: D000293:Adolescent; D003315:Cornea / Q000473:pathology* / Q000601:surgery; D057112:Corneal Perforation / Q000209:etiology / Q000601:surgery*; D003320:Corneal Ulcer / Q000209:etiology / Q000601:surgery*; D015817:Eye Infections / Q000150:complications* / Q000382:microbiology; D005260:Female; D006801:Humans; D007498:Iris / Q000473:pathology; D015948:Keratoplasty, Penetrating; D009344:Neisseria gonorrhoeae; D016870:Neisseriaceae Infections / Q000150:complications* / Q000382:microbiology; D011391:Prolapse; D019737:Transplants; D014786:Vision Disorders; D014792:Visual Acuity