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Corneal ulcer as the presenting feature of type 2 diabetes mellitus
  1. Muhammad Kutubi,
  2. Alaric Smith
  1. Ophthalmology, County Hospital Hereford, Hereford, UK
  1. Correspondence to Dr Muhammad Kutubi, mkutubi1{at}


A 60-year-old woman, with no significant medical or ophthalmic history, presented with a unilateral large corneal ulcer and hypopyon. Despite a severely injected conjunctiva and large corneal epithelial defect, the patient denied any discomfort in the eye. The ulcer was extremely slow to heal requiring prolonged treatment with topical and systemic broad-spectrum antibiotics. Due to the corneal opacification, fundal examination was not possible. Subsequent examination of the fellow eye revealed an appearance consistent with proliferative diabetic retinopathy. She was given treatment with panretinal laser photocoagulation. There was no history of diabetes and the patient denied experiencing any of the classical symptoms of hyperglycaemia. With blood tests revealing a raised plasma glucose and Haemoglobin A1c (HbA1c), a new diagnosis of diabetes mellitus was made. With the commencement of treatment for diabetes, there were signs of improvement in the corneal appearance.

  • diabetes
  • retina
  • ophthalmology
  • anterior chamber

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  • Contributors Both authors were directly involved in the management of the patient this case reports is based on. They have contributed to the writing of this case report.

  • 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.

  • Patient consent Obtained.

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

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