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Acute bilateral diffuse corneal opacity in a child.

Tsung-Jen Wang1, Cheng-Hsiang Hsiao, Fung-Rong Hu

  • 1Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Cornea
|April 7, 2007
PubMed
Summary
This summary is machine-generated.

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Acute bilateral corneal opacity in children is rare but can occur with bacterial blepharoconjunctivitis. Prompt antibiotic and steroid treatment is crucial for preserving vision in these cases.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Infectious Diseases

Background:

  • Bacterial blepharoconjunctivitis is a common ocular infection in children.
  • Corneal opacity is a potential complication, though bilateral acute cases are infrequent.

Observation:

  • An 18-month-old boy presented with bilateral red eyes, discharge, and periorbital eczema.
  • Sudden onset of bilateral corneal opacity developed one week after initial presentation.
  • Cultures revealed coagulase-negative staphylococcus and Propionibacterium acnes.

Findings:

  • Systemic and topical antibiotic therapy led to decreased ocular inflammation and opacity.
  • The left cornea cleared, but the right eye developed persistent opacity, neovascularization, and scarring.
  • Penetrating keratoplasty was required for the right eye due to sequelae.

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Implications:

  • Bacterial blepharokeratoconjunctivitis can lead to severe visual impairment from corneal opacity in children.
  • Ocular surface inflammation may result from bacterial toxins.
  • Early and aggressive combined antibiotic and corticosteroid treatment is vital for vision salvage.