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Infectious crystalline keratopathy.

G L Sutton1, R C Miller, L P Robinson

  • 1Ophthalmology Department, Westmead Hospital, Sydney, New South Wales, Australia.

Australian and New Zealand Journal of Ophthalmology
|May 1, 1990
PubMed
Summary

Infectious crystalline keratopathy, a rare corneal infection, can occur in patients using long-term topical steroids, especially after corneal grafts. This case highlights the importance of recognizing this condition and its unique presentation with minimal inflammation.

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Area of Science:

  • Ophthalmology
  • Microbiology

Background:

  • Infectious crystalline keratopathy (ICK) is a rare microbial keratitis.
  • It is characterized by stromal infiltration resembling crystals.
  • Long-term topical steroid use is a known risk factor.

Observation:

  • A 76-year-old patient presented with crystalline keratopathy in a corneal graft.
  • Microscopy revealed Gram-positive cocci with minimal inflammatory cells.
  • The patient had a history of long-term topical steroid use.

Findings:

  • This case represents the tenth reported instance of ICK globally and the first in Australia.
  • The findings suggest Streptococcus viridans as the likely causative agent.
  • The lack of inflammation is attributed to the immunosuppressive effect of topical steroids.

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Implications:

  • Prompt diagnosis and management are crucial for preserving vision.
  • Treatment involves discontinuing steroids, initiating antibiotic therapy, and potentially repeat corneal transplantation.
  • This case underscores the need for vigilance in patients with risk factors for ICK.