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Sight-threatening progressive corneo-scleral involvement in porphyria cutanea tarda
  1. Sonali Prasad1,
  2. Vidhata Vidhata2 and
  3. Subhash Prasad3
  1. 1Department of Ophthalomology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  2. 2Sadguru Netra Chikitsalaya, Chitrakoot, India
  3. 3Divyadrishti Eye Centre, Patna, India
  1. Correspondence to Dr Sonali Prasad; sonalipd92{at}


Porphyria cutanea tarda is the most common type of porphyria. It is associated with a deficiency of uroporphyrinogen decarboxylase enzyme responsible for heme synthesis. Clinical manifestations are predominantly dermatological and very rarely present with ocular involvement. Although scleral thinning in the interpalpebral area is a well-documented entity, sight-threatening corneal involvement is rarely described. We, herein report a case of a 58-year-old man who presented with ocular surface dryness, photophobia and mild redness. Slit-lamp biomicroscopy revealed corneo-scleral thinning in both eyes. The diagnosis was confirmed with a urine porphyrin test, serum iron and serum ferritin levels. We started him on conservative management after which he was lost to follow-up. He presented again after 6 years with total corneal opacification and progressive loss of vision in the right eye.

  • eye
  • immunology
  • dermatology

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  • Contributors SonaliP: methodology, conceptualisation, visualisation, software, writing original draft, investigations. VidhataV: analysis, data curation, writing review and editing. SubhashP: resources, formal analysis, supervision, project administration.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.