DR. NEHA ARORA

DR. RADHA K. ANNAMALAI, DR..MUTHAYYA MUTHUKUMAR

Abstract

38-year-old man presented with pain and discharge in left eye for 2 days. Known case of Pemphigus foliaceus, treated with IV steroids, switched to oral steroids (Prednisolone 60 mg daily) and Cyclophosphamide. Examination of left eye showed profuse discharge and 8×8 mm elevated lesion in cornea, involving visual axis; with necrotic debris, stromal infiltrates, central thinning and 2 mm hypopyon. Corneal scraping revealed Pseudomonas aeruginosa. Fortified Amikacin drops (susceptible) were started along with cycloplegics, lubricants, Tab Ciprofloxacin. He improved, with reduction in symptoms, size of infiltrates and epithelial defect and gradual re-epithelialisation, despite inability to stop steroids. Central thinning and facet remained. We present this case for its rarity of a highly aggressive infection in a patient on long term steroids, where medical therapy alone staved off complications, maintained globe integrity and ameliorated symptoms, leaving behind non-healing corneal ulcer.