title: Keratopathy due to ophthalmic drug abuse with corneal melting and perforation presenting as Mooren-like ulcer: A case report.
abstract: The present report describes the clinical course and treatment of a Mooren-like ulcer associated with abuse of topical anesthetics and dexamethasone. A 38-year-old male physician treated himself with lidocaine, tetracaine and dexamethasone (DEX) eye drops for severe pain and decline of vision in both eyes. After six months of treatment, his right cornea exhibited annular melting with full-thickness stromal infiltration at the limbus and central corneal haze. His left cornea was completely melted and exhibited iris prolapse. The patient was treated with topical antibiotics, lubricants and underwent a binocular keratoplasty. The surgery was successful and after eight months the postoperative best-corrected visual acuities were counting fingers in the right eye and light perception in the left eye. In summary, this report documents a severe case of keratopathy presenting as Mooren-like ulcer caused by topical anesthetics and DEX, which were treated via keratoplasty, resulting in useful vision being retained.
authors.affiliation: Department of Ophthalmology, First Affiliated Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Ophthalmology, First Affiliated Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Xiao-Ru
authors.initials: XR
authors.lastname: Shi
authors.affiliation: Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: Feihong
authors.initials: F
authors.lastname: Xu
authors.affiliation: Department of Ophthalmology, First Affiliated Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Jiang
authors.affiliation: Department of Ophthalmology, First Affiliated Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Rong
authors.initials: R
authors.lastname: Huang
authors.affiliation: Department of Ophthalmology, First Affiliated Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jia
keywords: anesthetic abuse; dexamethasone; keratopathy; keratoplasty