Posters

Corneal involvement in tyrosinemia type II initially mistaken for herpetic keratitis in an adult: a case report

Poster Details

First Author: S. Khochtali TUNISIA

Co Author(s):    S. Zina   N. Abroug   A. Mahmoud   S. Ben Yahia   M. Khairallah        

Abstract Details

Purpose:

To report the case of a 40-year-old woman who presented with corneal lesions secondary to tyrosinemia type II, that were initially mistaken for herpetic keratitis.

Setting:

Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.

Methods:

A case report

Results:

A 40-year-old woman, with a history of mild mental retardation, presented with a painful red right eye. Marginal inferior corneal infiltration and ulcer were found. The patient received valaciclovir (2g a day), and then topical fluorometholone. Three months later, the patient consulted with bilateral ocular complaints. Slit-lamp examination revealed two corneal marginal ulcers in the right eye and a pseudodentritic inferior keratitis in the left eye. Work-up showed a plantar hyperkeratosis and high serum tyrosine levels. The diagnosis of Richner Hanhart syndrome was made. The patient was prescribed tyrosine- and phenylalanine-restricted diet, and lubricants. Two months later, corneal lesions healed.

Conclusions:

Richner Hanhart syndrome (Tyrosinemia type II) should be suspected in patients with bilateral pseudodendritic corneal lesions unresponsive to antiviral therapy, even in adults. Systemic manifestations including palmoplantar keratosis and mental retardation should be looked for.

Financial Disclosure:

NONE