DR. JANANI R

Dr. DAS GOPAL KRUSHNA

Abstract

A 59 year man presented with redness,watering(no pain) in his both eyes since 2 months. Anterior segment examination revealed peripheral punched out temporal corneal ulcer in both cornea.Sensation was intact.A trial of fortified antibiotics was started along with systemic evaluation for infective,collagen and autoimmune diseases which turned to be negative.His ESR was elevated with sputum Tuberculosis and Rheumatoid factor negative.After ruling out infectious ulcer,temporary tarsorrhaphy was done to promote corneal healing. Topical Cyclosporine 0.05% eyedrops was started along with low dose topical steroids and oral steroids.After a week,his corneal ulcers responded well with reduction in symptoms and ulcer size.Steroids was tapered and Cyclosporine was continued for two months and the patient is followed up for systemic complaints and recurrence.This case highlights the importance of immunomodulators like topical cyclosporine in the management of recalcitrant chronic corneal ulcers.