Keratoconjunctivitis as a Single Entity in X-linked Agammaglobulinemia?
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Updated: Sep 27, 2025

Induction of Ocular Surface Inflammation and Collection of Involved Tissues
Published on: August 4, 2022
Stefan Mielke1, Bastian Grundel1, Sebastian M Schmidt2
1Department of Ophthalmology, University Medical Center, Greifswald, Germany.
Purpose:
To report a case of a male patient with a severe corneal and conjunctival immunopathy likely caused by an X-linked agammaglobulinemia.
Methods:
A clinical case report with observation results from 2001-2021.
Results:
A severe corneal immunopathy of both eyes is reported in a retrospective long-term observation of nearly twenty years in a 32-year-old male patient with X-linked agammaglobulinemia (XLA). A chronic progressive corneal scarring with a loss of visual acuity and typical symptoms of a phlyctenular keratoconjunctivitis were observed.
Conclusion:
Whereas steroid eye drops like dexamethasone could control the symptoms and the corneal scarring progression as short time therapy options, ciclosporin A eye drops showed problems in therapy adherence in long-time use. Antibiotic eye drops supported the anti-inflammatory therapy effects, but no typical pathogen was detected. Antineovascular subconjunctival application did not show any relevant effect in one-time use. Artificial tears were needed as basic therapy.
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