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[Followup of chicken pox keratitis. Anatomic-clinical case report]
F D'hermies1, P Ellies, A Meyer
1Service d'Ophtalmologie, Hôtel Dieu, 1 place du parvis Notre-Dame, 75181 Paris cedex 04, France.
Insights
Chicken pox can cause rare, long-term corneal scarring and vision loss in adults. This case highlights the need for prompt corneal allograft due to perforation risk.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Chicken pox (varicella-zoster virus) is a common childhood illness.
- Corneal involvement in chicken pox is typically less severe than in measles.
- Ocular complications can occasionally occur, impacting vision.
Observation:
- A 59-year-old male presented with vision loss in his left eye.
- History revealed chicken pox infection at age 7, affecting the left cornea.
- Examination showed a central epithelial defect, corneal thinning, and stromal opacity in the left eye.
Findings:
- Histopathology of the corneal button revealed central thinning and epithelial thickening.
- Disorganized corneal stroma with irregular collagen bundles was noted.
- No inflammatory cells were present, consistent with a corneal scar.
Implications:
- This case demonstrates a rare instance of delayed corneal scarring from childhood chicken pox.
- The patient required a corneal allograft due to the risk of perforation.
- Highlights the importance of recognizing and managing late-onset ocular complications of viral infections.
Abstract:
Chicken pox is a very common infectious disease in children. Its corneal involvement is less serious than with measles, which may lead to blindness in numerous developing countries. However, with occasional cases occur. A case of a 59-year-old male patient whose left cornea was involved during a chicken pox infection at the age of 7 is reported. More recently, the vision of the right eye was normal at 20/20 and reduced to visual perception in the affected left eye. Corneal sensitivity was maintained in the left eye, which, however exhibited a central epithelial defect. A central round opacity of the left corneal stroma was believed to be the scar resulting from a previous disciform keratitis. The left central cornea was thinned and there was neither an anterior chamber flare nor new corneal vessels. This corneal condition required a corneal allograft, performed quickly because of the potential risk of perforation. Histopathological study of the corneal button showed a central corneal thinning with an increase in epithelial thickness. The corneal stroma was disorganized, with irregular collagen bundles. No inflammatory cells could be observed, however. All the histopathological changes observed were those of a corneal scar.