Posters

Corneal ulcer as the first feature of type II diabetes mellitus: a case report

Poster Details

First Author: A.Geamanu-Panca ROMANIA

Co Author(s): A. Geamanu   R. Cherrak   O. Babalau   M. Totir           

Abstract Details

Purpose:

We describe the case of a 69-years old woman, with no significant medical history, that presented with a large nasal corneal ulcer and hypopyon of the left eye, severely injected conjunctiva but no symptoms of ocular pain.

Setting:

Diabetes mellitus is a chronic disease, one of the most common systemic diseases worldwide caused by the inadequate insulin production. Diabetic neuropathy and retinal complications are well recognized by the ophthalmologists, but the ocular surface effects are poorly known.

Methods:

In our case report, healing of the corneal ulcer of the LE was very slow despite prolonged treatment with topical and systemic broad-spectrum antibiotics. Subsequent examination of the right eye revealed a neurotrophic ulcer, stage II, that appeared four years ago. Due to the corneal and lens opacification the ocular fundus visualisation was impossible in both eyes. Biological tests showed increased levels of plasma glucose and HbA1C that conducted to the diagnosis of diabetes mellitus. Starting treatment for diabetes, oral therapy, there were signs of healing the corneal defect.

Results:

In diabetes, changes in the tear film and ocular surface microbiome, the epithelial fragility and reduced epithelial adhesion to the underling basement membrane are the mechanisms that increase the susceptibility to corneal defects and infection.

Conclusions:

We report that corneal ulcer could be considered as a first sign of type II diabetes mellitus, even in case of a patient without a preceding diagnosis of the diabetes. Final disclosure: The authors were directly involved in the management of the patient this case report is based on. They wrote this case report for ESCRS Winter Congress, Marrakech, 2020.

Financial Disclosure:

... gains financially from competing product or procedure, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... is employed by a competing company, ... has significant investment interest in a company producing, developing or supplying product or procedure presented