Case Studies

 Case 4.12 Atopic keratoconjunctivitis

A 38-year-old businessman with long-standing atopic eczema presented with intensely itching eyes. His eyelids were puffy and there was a purulent conjunctivitis with diffuse punctate keratitis of the lower cornea. Sodium cromoglycate and simple lubricants proved ineffective, and he needed a combination of topical steroids and an antibiotic to keep the keratoconjunctivitis under control. His long-term treatment will be carefully supervised because such steroid-antibiotic combinations carry a risk of sensitivity reactions to the topical antibiotic, raised intraocular pressure secondary to the topical steroid, and herpes simplex keratitis.