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Fuchs' superficial marginal keratitis
J R Bierly1, J P Dunn, C R Dawson
1Francis I. Proctor Foundation, University of California, San Francisco 94143.
Abstract:
We studied three cases of Fuchs' superficial marginal keratitis, an uncommon condition that is characterized by intermittent, recurrent episodes of ocular irritation accompanied by marginal infiltrates and that is followed by progressive marginal superficial stromal thinning. Usually, it has an indolent course with spontaneous remission, and good visual acuity is preserved. In advanced cases, a pseudopterygium develops in the area of marginal thinning. The pseudopterygium encroaches onto the cornea over a period of years, but spares the central cornea. In two of our three cases, the degree of thinning beneath the pseudopterygium became marked. This led to corneal perforation during pseudopterygium excision in one case, and after blunt trauma in the other. These complications indicate the need for special precautions when caring for these patients.
Insights
Fuchs' superficial marginal keratitis can lead to severe corneal thinning and potentially perforation, especially when a pseudopterygium develops. Careful management is crucial for patients with this uncommon eye condition.
Area of Science:
- Ophthalmology
- Corneal Diseases
Background:
- Fuchs' superficial marginal keratitis is an uncommon condition causing recurrent ocular irritation and marginal infiltrates.
- It typically presents with indolent progression and spontaneous remission, preserving visual acuity.
Observation:
- Advanced cases develop pseudopterygium in areas of marginal stromal thinning.
- Two of three studied cases showed marked thinning beneath the pseudopterygium.
Findings:
- Corneal perforation occurred in one case during pseudopterygium excision and in another after blunt trauma.
- These severe complications highlight potential risks associated with this condition.
Implications:
- Patients with Fuchs' superficial marginal keratitis, particularly those with pseudopterygium, require specialized and cautious eye care.
- Early recognition and management of pseudopterygium may be necessary to prevent sight-threatening complications.
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