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Case Reports: Reminder of important clinical lesson
Curious case of chronic corneal oedema
  1. Ritika Mukhija,
  2. Sam Kanavati and
  3. Mayank A Nanavaty
  1. Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, Sussex, UK
  1. Correspondence to Mayank A Nanavaty; mayank.nanavaty{at}nhs.net

Abstract

An 89-year-old man with multiple episodes of inferior corneal oedema and low-grade anterior segment inflammation over 18 months was diagnosed and managed as viral keratitis; however, the episodes kept recurring every time treatment, vis-à-vis topical steroids, were tapered or stopped. History of cataract surgery few months prior to onset of the symptoms, lack of other features of viral keratitis, such as keratic precipitates and inferior corneal oedema in the presence of slight pupillary peaking led to the suspicion of either a retained lens fragment (RLF) or other possible iatrogenic insult. This was confirmed by anterior segment optical coherence tomogram, which revealed the RLF in inferior angle; this was removed surgically as an emergency procedure. This resulted in significant improvement in the corneal oedema, as well as marked symptomatic relief confirmed by the patient.

  • Eye
  • infections
  • anterior chamber
  • iris
  • pupil

https://doi.org/10.1136/bcr-2021-246334

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    Footnotes

    • Twitter @dr_ritika_eye, @NanavatyMA

    • Contributors RM: Involved in management of the patient, literature search, manuscript drafting and final approval. SK: Involved in literature search, manuscript drafting and final approval. MAN: Diagnosed and planned the management, manuscript drafting and final approval.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.