Spontaneous Corneal perforation in rheumatoid arthritis

ABSTRACT

A 67-year-old woman with advanced rheumatoid arthritis and dry eye syndrome developed mid-peripheral inferior corneal thinning with ulceration in both eyes about two weeks after beginning the use of antibiotic-steroid combination drops prescribed for episcleritis in the left eye and filamentary keratitis in the right eye. A few days later, there occurred a spontaneous perforation of the right cornea. These complications developed despite regular and frequent use of tear substitute drops for nearly three years. The corneal perforation responded well to penetrating keratoplasty. A prophylactic tarsorrhaphy prevented perforation in the other eye. [Pakistan Journal of Ophthalmology 831, 46, April, 1992]