PMC3031186_01
PMC3031186_02
(A) Colour photograph of the left eye prior to evisceration (removal of the contents of the eye). Note the severe conjunctival congestion and scleritis, opaque cornea, large corneal perforation (arrowed) and hypopyon (pus cells inside the anterior chamber of the eye) indicating the classic signs of a severe, fulminant and destructive infection, which emerged following treatment for an autoimmune peripheral ulcerative keratitis without excluding a secondary corneal infection; (B) similarly, the right eye at presentation did not demonstrate the cardinal features of inflammation showing a discrete crescenteric area of corneal opacity between 3 o'clock and 6 o'clock (arrow); and (C) excavated (thinned) area suggestive of corneal 'melt' (arrow)
SHORTS-10-07901.jpg
PMC3031186_04_SHORTS-10-07901.jpg
SHORTS-10-079F1
Her visual acuity was reduced to 6/18 and she was found to have an identical peripheral infero-temporal crescenteric area of keratitis with minimal associated corneal infiltration, but significant corneal melt with up to 70% thinning (Figures 1b and 1c).
PMC3031186_03
PMC3031186_04
(A) Colour photograph of the left eye prior to evisceration (removal of the contents of the eye). Note the severe conjunctival congestion and scleritis, opaque cornea, large corneal perforation (arrowed) and hypopyon (pus cells inside the anterior chamber of the eye) indicating the classic signs of a severe, fulminant and destructive infection, which emerged following treatment for an autoimmune peripheral ulcerative keratitis without excluding a secondary corneal infection; (B) similarly, the right eye at presentation did not demonstrate the cardinal features of inflammation showing a discrete crescenteric area of corneal opacity between 3 o'clock and 6 o'clock (arrow); and (C) excavated (thinned) area suggestive of corneal 'melt' (arrow)
SHORTS-10-07901.jpg
PMC3031186_04_SHORTS-10-07901.jpg
SHORTS-10-079F1
Her visual acuity was reduced to 6/18 and she was found to have an identical peripheral infero-temporal crescenteric area of keratitis with minimal associated corneal infiltration, but significant corneal melt with up to 70% thinning (Figures 1b and 1c).
PMC3031186_05
Colour photographs of the right eye at 12 months after appropriate staged introduction of treatment for corneal infection followed by treatment for autoimmune peripheral ulcerative keratitis administered in quick succession. Note the crescenteric area of opacity has resolved, leaving only a shallow area of thinning with minimal scarring
SHORTS-10-07902.jpg
PMC3031186_05_SHORTS-10-07902.jpg
SHORTS-10-079F2
Over the subsequent 12 months there was no recurrence of ocular inflammation with her visual acuity recovering to 6/12 (Figure 2).