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Idiopathic stromal keratitis resembling central toxic keratopathy

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Session Details

Session Title: Cornea - Medical

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 09:39

Venue: Room 17

First Author: : L.De Benito-Llopis UK

Co Author(s): :    V. Wagh   D. O'Brart                 

Abstract Details

Purpose:

To report a case of idiopathic stromal keratitis resembling central toxic keratopathy.

Setting:

University Hospital,St Thomas Hospital, London, UK

Methods:

A 28-year-old previously emmetropic woman presented with two-day history of bilateral photophobia and blurred vision. She had no history of corneal surgery, trauma or contact lens use.

Results:

Snellen unaided acuity was 6/12 bilaterally. She refracted to 6/12 with +4.50/-0.5 diopter (D) x 450 in the right eye and +6.50/-1.00D x 1650 in the left eye. She had bilateral anterior stromal infiltration of her central corneas, with no overlying epithelial defect and intact sensation. Corneal tomography showed central corneal thinning with thicknesses of 388 um right eye and 394 um in the left eye. There was bilateral central corneal flattening, with keratometry values of 41.3D in the right eye and 40.7D in the left eye. The patient was commenced on topical corticosteroids. Over 10 weeks there was a return of her unaided acuity to 6/6 with emmetropization of her refractive status and thickening of her central cornea.

Conclusions:

The clinical findings in our patient resemble those of CTK post-refractive surgery cases, suggesting a similar mechanism. This is the first report of a patient presenting with a CTK-like syndrome in the absence previous kerato-refractive surgery or contact lens wear. The pathophysiology of this condition remains elusive and requires further investigation.

Financial Interest:

NONE

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