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Recurrent conjunctivitis as a presentation of munchausen syndrome by proxy
Darrell E Baskin1, Fernando Stein, David K Coats
1Cullen Eye Institute, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA.
Purpose:
To report a case of Munchausen syndrome by proxy, which manifested as recurrent bilateral keratoconjunctivitis in an infant.
Design:
Interventional case report.
Intervention:
The patient underwent numerous diagnostic studies, including two endoscopies, skin biopsy, conjunctival pH measurement, and a skeletal survey. She underwent daily eye examinations until the corneal and conjunctival epithelial defects resolved.
Main Outcome Measure:
Resolution of cutaneous, mucosal, corneal, and conjunctival epithelial defects.
Results:
A punch biopsy of the right postauricular area was performed, and pathology subsequently determined that the findings seemed to be the result of an exogenous injury. The conjunctival pH was 8.0, consistent with exposure to an exogenous, caustic agent. The acute ocular lesions resolved.
Conclusions:
Munchausen syndrome by proxy can be seen with ophthalmic manifestations and should be considered in the differential diagnosis when ocular abnormalities cannot be explained after a thorough and methodical evaluation.