CORNEAL INFILTRATION AFTER RECURRENT CORNEAL EPITHELIAL EROSION

Aims-To describe the clinical features of patients with a history of r ecurrent corneal epithelial erosion who develop acute corneal infiltra tion. Methods-The records were reviewed of patients who had previously been examined and treated for recurrent corneal epithelial erosion an d who presented again with signs suggestive of a microbial keratitis. Results-11 patients were described; one patient presented with similar signs on two occasions. There was typically a paracentral epithelial defect >2 mm in diameter with an associated stromal infiltrate and an intense anterior uveitis. Three patients had a hypopyon, and four deve loped a subepithelial ring infiltrate. Samples were taken for microsco py and bacterial culture, with a positive isolate from two of 12 episo des (16%). Treatment with topical antibiotics and topical corticostero id resulted in rapid epithelialisation and a reduction inflammation. T here was good visual outcome for all eyes, with a recurrence or sympto ms of epithelial erosion in only one eye after a mean follow up period of 18 months. Conclusions-Corneal infiltrates are an uncommon complic ation of recurrent corneal epithelial erosion. Despite the intensity o f the infiltration the majority are culture negative using established techniques. There is typically rapid resolution and a good visual out come, with a tendency for the episode to mark the end of further sympt oms of epithelial erosion.