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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

Summary

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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.

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.