Posters

Always suggest a viral necrotizing stromal keratitis, in the case of a corneal abscess

Poster Details

First Author: N.Boutimzine MOROCCO

Co Author(s):    K. Belkhadir   O. Cherkaoui   M. Hmidchat   A. Amazouzi   R. Daoudi        

Abstract Details

Purpose:

The diagnosis of viral herpetic keratitis is usually easy in the case of a dendritic or interstitial corneal injury. It becomes harder in case of rarer forms such as necrotizing keratitis, which can be difficult to differentiate from a bacterial infection, especially corneal abscesses.

Setting:

Department of Ophthalmology A, Ibn Sina University Hospital, Rabat, Morocco

Methods:

We would like to report three clinical cases. The first case was a female patient, with a history of unilateral herpetic interstitial keratitis. She had an upper necrotizing stromal keratitis lesion, associated with epithelial ulceration, and interstitial keratitis altering the visual acuity. In the second case, the corneal involvement combined linear endothelitis, a hypopion, a superficial ulceration facing an inflammatory infiltrate with the appearance of a deep abscess, a hypertensive uveitis and episcleritis. The third case was a 76 years old man with no medical history, which had a large epithelial ulcer with a stromal necrotizing keratitis in its center.

Results:

These lesions are suggestive of viral stromal necrosis. Treatment with high doses intravenous antiviral drugs, associated with local corticosteroid after healing of superficial injuries, allowed the regression of functional and physical signs.

Conclusions:

Although infrequent, necrotizing viral keratitis should be suggested in the case of corneal abscess not responding to fortified eye drops, especially in the case of recurrent lesions.

Financial Disclosure:

NONE