ATYPICAL HERPETIC KERATITIS PRESENTING AS A LARGE CORNEAL INFILTRATE IN A CONTACT LENS WEARER

Published 2023 - 27th ESCRS Winter Meeting

Reference: P145 | Type: Presented Poster & Poster Submission | DOI: 10.82333/nzmb-3a04

Authors: Zineb Hilali* ¹ , Sbai Latifa ¹ , Azarkan Boutayna ¹ , Cherkaoui Lalla ouafa ¹ , Amazouzi Abdellah ¹

¹OPHTALMOLOGY,IBN SINA HOSPITAL,RABAT,Morocco

Purpose

To report the clinical presentation and management of a case of a 27 year old patient who has been wearing soft contact lenses for myopia for 08 years and who presented an infectious keratitis, and to raise awareness of the risk of wearing contact lenses.

Setting

Ophtalmology A department, Ibn sina hospital, Rabat -Morocco.

Methods

We report the case of a 27-year-old patient who presented to the emergency room with a painful red eye and a decrease in visual acuity that had been evolving for 2 days. The patient was a contact lens wearer for myopia and the interrogation showed the notion of night-time wearing of these lenses.

Results

On clinical examination, visual acuity is at "finger count". On biomicroscopic examination, we note conjunctival hyperhemia, a paracentral stromal infiltrate with corneal ulcer and edema. There are no retrodescemetic precipitates and the anterior chamber is quiet. A complete microbiological sample was taken, including bacteriological, mycotic and viral samples.

The patient was put under eyewash, artificial tears, antibiotic eyewash (quinolones) and an oral antiviral treatment (valaciclovir: 3g per day). Local corticosteroid therapy was started after 48 hours of treatment.

The evolution was marked by an improvement in visual acuity, healing of the corneal ulcer and regression of the corneal oedema, with persistence of a stromal scar infiltrate.

Conclusion

The management of infectious keratitis is a diagnostic and therapeutic emergency in the contact lens wearer. Herpetic keratitis should not be excluded, although it is rare.