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Iris Fixation via External Pentagram Suturing

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Phlyctenular keratoconjunctivitis a potentially blinding disorder.

J R Juberias¹, M Calonge, J Montero

¹Ocular Immunology Unit, University of Valladolid, Valladolid, Spain.

Ocular Immunology and Inflammation

|July 26, 2012

Summary

Phlyctenular keratoconjunctivitis, an allergic eye reaction, can cause severe vision loss if untreated. This case highlights a rare bacterial cause and a novel lacrimal gland complication.

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Area of Science:

Ophthalmology
Immunology
Microbiology

Background:

Phlyctenular keratoconjunctivitis is a delayed hypersensitivity reaction to foreign proteins, often bacterial.
It commonly affects children and young adults sensitized to Staphylococcus aureus on the eyelids.
Manifestations include conjunctival and corneal inflammation.

Purpose of the Study:

To report a case of phlyctenular keratoconjunctivitis with unusual bacterial etiology and complications.
To emphasize the potential for vision impairment from this condition.
To document secondary lacrimal gland hypertrophy as a previously unreported complication.

Main Methods:

A 14-year-old female with severe keratoconjunctivitis underwent a comprehensive ocular examination.
Diagnostic workup included blood tests, cultures, and lid hygiene.
Treatment involved topical antibiotics, steroids, and oral doxycycline.

Main Results:

Phlyctenular keratoconjunctivitis was diagnosed, with Streptoccocus viridans identified on the lid margins.
Treatment resolved active inflammation and lacrimal gland enlargement.
Residual corneal scarring resulted in permanent visual acuity reduction.

Conclusions:

Untreated phlyctenular keratoconjunctivitis can lead to blinding consequences.
Streptoccocus viridans is an uncommon cause of this condition.
Secondary lacrimal gland hypertrophy is a novel complication of phlyctenular keratoconjunctivitis.