OCULAR SURFACE FEATURES OF REACTIVE ARTHIRITIS

Reactive arthritis, formerly known as Reiter's syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. By the time the patient presents with symptoms, often the "trigger" infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.The manifestations of reactive arthritis include the following triad of symptoms: an inflammatory arthritis of large joints, inflammation of the eyes in the form of conjunctivitis or uveitis, and urethritis in men or cervicitis in women. ocular manifestations range from the usual bilateral conjonctivitis to rare keratitis and uveitis.

Ophthalmology department, Mohammed VI university hospital, Oujda, Morocco

we report the case of a 30 Y.O presenting a reactive arthirtis withe positive HLA-B27 and two episodes of ocular manifestations : bilateral conjunctivitis followed by keratitis

a 30 Y.O man with a history of multiple sexual intercourses was admitted to emergency for a bilatarel red eyes with mild pain. He presented multiple invalidant joints athrtitis intresting knees, hands and feet. the symptoms started weeks after he presented " pain while peeing". a bilateral conjunctivitis was diagnosed treated by local nsaids and antiobiotiics , and he was reffered to internal medicine, where the screening showed a positive uretral prelevement for C.trachomatis with positive HLA b27. he presented a mild improvement of joints and ocular symptoms after receiving NSAIDs. A month after he presented a second episode of ocular pain with blurry vision with VA at 0.3 , corneal ulceration , for which he received anti-viral treatement followed by corticosteroids with excellent improvement , then reffered to internal medicine 

our case illustrates a rare form of ocular manifestations of Reiter disease : Keratitis. Since this form is rare, we preffered to use a anti-viral cover before starting a anti-inflammaroty treatement for our patient.