Rubeola keratitis: a photographic study of corneal lesions

Detailed description of the morphology of rubeola keratitis lesions is missing from textbooks and published reports. We performed a detailed analysis of rubeola keratitis lesions by using a photographic slit lamp and ophthalmic dyes.

Thirty-four eyes of 17 male young adult patients with rubeola keratitis were examined. Patients were examined at 3.6 days after the development of rash. Ocular symptoms were recorded, and patients underwent complete ocular examination including photography of corneal lesions, with and without instillation of ophthalmic dyes (rose Bengal and fluorescein).

Patients complained of foreign-body sensation (88%), photophobia (65%), tearing (65%), and burning sensation (47%). Visual acuity was unaffected (26%) or mildly affected (71%). Conjunctivitis was observed in 74% and keratitis in 100% of eyes. Corneal photographs were studied, and 4 types of corneal lesions were identified: small, punctate epithelial lesions staining only with rose Bengal (100%); small, round, or larger and irregular when they coalesced epithelial defects (100%); large or tiny filaments (39%); and target lesions (100%). Target lesions appeared when both dyes were instilled. The outline of target lesions stained with rose Bengal, and they consisted of a pattern of alternating concentric zones of staining with rose Bengal and fluorescein. Keratitis was strictly confined to the epithelium and resolved gradually in all patients without the appearance of complications.

Rubeola keratitis in healthy young adults runs a benign course. Recognition of the specific to rubeola keratitis corneal target lesions could aid in the differential diagnosis and prevent the transmission of the disease.