Year: 2025
Type: conference-abstract
Abstract: Case 40-year female. Referred after 9 years of treatment as dry eyes/blepharitis/allergic eye disease secondary to eczema. Very mild eczema controlled on emollients, no significant periocular involvement. Severe bilateral ocular surface inflammation at presentation- severe conjunctival inflammation/limbitis/supero-temporal inflammatory nodule in right eye encroaching on cornea, inferior forniceal shortening in both eyes, bilateral dense SPK. Previous conjunctival biopsies negative for pemphigoid/neoplasia. Full auto-immune profile negative.Initial response to IV Methyl Pred + MMF but left fungal keratitis, anaesthetic abuse, therapeutic PK, recurrence, evisceration within 6 weeks.Right only eye- severe SPK with chronic inflammation despite mycophenolate 1.5 gms BD, oral cyclosporine + never managed to reduce prednisolone below 30 mgs. Extreme conj hyperactivity with severe response to any stimulus- plugs/an increasing number of topical drops/fluorescein. Now started on cyclophosphamide + IV methylprednisolone vasculitis regime as recent acute flare up. But also at high risk of infection as persistent dense SPK with recurrent small epithelial defects despite autologous serum/max lubricants. Also patient has low pain tolerance and anxiety/depression making overall management challenging.
Author: Seema Anand
Institution: Leeds Teaching Hospitals NHS Trust
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4412408317