A Case of Keratoconjunctivitis Sicca Associated Idiopathic Hypereosinophilic Syndrome

ABSTRACT

PURPOSE: To report a case of the keratoconjunctivitis sicca (KCS) associated idiopathic hypereosinophilic syndrome (IHES). METHODS: We present a report and review of a 53-year-old man who suffered from IHES and KCS. The ocular examination showed conjunctival papillary hypertrophy, interpalpebral corneal and conjunctival punctate staining with fluorescein dye, and peripheral corneal neovascularization. His Schirmer I test results were nearly zero mm of wetting in both eyes. Impression cytology showed squamous metaplasia. RESULTS: He had treated with low dose systemic steroid since October 2003. Because he showed a side effect of steroid induced myopathy, we could not increase the dosage. We added topical steroid (Pred Forte(R)), conservative free artificial tear and topical antibiotics, after which his ocular condition improved. Neovascularization was regressed, punctate staining decreased, and his visual acuity increased to 20/25 2 months later. CONCLUSIONS: This case demonstrates that the KCS can be associated with IHES and be treated with systemic and topical steroid.