Unusual neutrophil infiltration under the soft contact lens in a patient with Behçet's disease

Behçet's disease (BD) characterized by multisystemic disorders has many kinds of ocular involvement. We report one case of BD with unusual neutrophil infiltration under a soft contact lens (SCL).

A 31-year-old woman diagnosed as having BD exhibited bilateral recurrent phlyctenular keratitis and finally developed corneal perforation in the cornea of her right eye.

A therapeutic SCL was immediately fitted on the right cornea as a bandage and another SCL on the left, as prophylaxis. White gelatinous membrane suddenly appeared between the bandage SCL and the cornea in the left eye. After peeling off this gelatinous membrane from the cornea, we examined it after hematoxylin-eosin staining. We also measured the levels of interleukin-8 (IL-8) both in the tears of the patient and on the surface of the SCL. A great amount of neutrophils had infiltrated into this gelatinous membrane. Laboratory data showed a marked increase of IL-8 levels both on the SCL and in the reflex tears (right SCL, 4980 pg/mL; left SCL, 6810 pg/mL. Reflex tears: right, 2080 pg/mL; left, 2170 pg/mL).

This case emphasizes the association between the IL-8 level and the disease activity in BD, and provides additional evidence that a BD attack can be induced on the ocular surface under certain conditions.