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Updated: Apr 23, 2026

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Peripheral ulcerative keratitis: Our challenging experience.

Bandar Al-Qahtani1, Salman Asghar2, Hassan Mohammad Al-Taweel3

  • 1Jordanian Board of Ophthalmology, Chief Consultant Ophthalmologist, Hera General Hospital, Makkah, Saudi Arabia.

Saudi Journal of Ophthalmology : Official Journal of the Saudi Ophthalmological Society
|October 4, 2014
PubMed
Summary

Peripheral ulcerative keratitis in a patient with multiple comorbidities was initially stable but rapidly thinned. Despite medical management, perforation occurred and was successfully treated with cyanoacrylate glue and a bandage contact lens.

Keywords:
Amniotic membrane transplantationConnective tissue diseasesImmune complex depositionImpending perforationPeripheral corneal thinningPeripheral ulcerative keratitisTopical cyclosporine eye drops

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Area of Science:

  • Ophthalmology
  • Nephrology
  • Immunology

Background:

  • A 52-year-old male with a complex medical history including retinitis pigmentosa, diabetes mellitus, hypertension, and renal failure presented with peripheral ulcerative keratitis.
  • The patient was undergoing weekly hemodialysis for renal failure.

Purpose of the Study:

  • To describe the clinical course and management of peripheral ulcerative keratitis in a patient with significant systemic comorbidities.
  • To highlight the successful management of corneal perforation in this high-risk patient.

Main Methods:

  • Clinical observation and management of peripheral ulcerative keratitis based on ulcer characteristics and visual acuity.
  • Conservative treatment including medical management and eye protection with a shield.
  • Surgical management of corneal perforation using cyanoacrylate glue and a bandage contact lens.

Main Results:

  • The peripheral corneal ulcer remained stable for eight months before progressing to rapid thinning.
  • Despite medical and conservative treatment, the patient experienced a corneal perforation due to minor trauma.
  • Successful sealing of the perforation with cyanoacrylate glue and a bandage contact lens led to anterior chamber reformation.

Conclusions:

  • Peripheral ulcerative keratitis can present unique challenges in patients with multiple systemic comorbidities.
  • Prompt and appropriate management, including cyanoacrylate glue for perforation, can lead to favorable outcomes even in complex cases.
  • A multidisciplinary approach is crucial for managing patients with severe ocular conditions and significant systemic diseases.