Peripheral corneal infiltrates in inflammatory bowel disease

Area of Science:

• Ophthalmology
• Gastroenterology
• Immunology

Background:

• Inflammatory bowel disease (IBD), encompassing ulcerative colitis and Crohn's disease, is associated with various extraintestinal manifestations.
• Ocular complications in IBD patients are well-documented, though corneal involvement is less common.

Observation:

• Three patients (two with ulcerative colitis, one with Crohn's disease) presented with unilateral corneal lesions.
• These lesions were characterized as small, peripheral, subepithelial infiltrates.
• Patients experienced mild irritative ocular symptoms, and importantly, no bacterial infection was evident.

Findings:

• The corneal lesions in these IBD patients were not indicative of staphylococcal infection.
• The patients' underlying intestinal disease activity was inactive at the time of ocular presentation.
• Rapid resolution of corneal infiltrates was achieved using topical corticosteroids or systemic indomethacin.

Implications:

• This suggests a potential immune-mediated or inflammatory etiology for these specific corneal lesions in IBD.
• Prompt diagnosis and treatment with anti-inflammatory agents can lead to favorable visual outcomes.
• Highlights the importance of ophthalmologic evaluation in IBD patients presenting with ocular symptoms.