Limbal and bulbar inflammatory nodules in a patient with pityriasis lichenoides et varioliformis acuta.

CLINICAL REPORT: We report a case of a 42-year old lady with recurrent bilateral nodular conjunctival inflammation following a diffuse papulo-vesicular rash, mainly over her trunk and scalp. Slitlamp examination revealed limbal and bulbar inflammatory nodules with secondary corneal involvement. DISCUSSION: Pityriasis lichenoides is considered to be a spectrum of uncommon, acquired maculo-papular skin eruptions. The diagnosis is made by the combination of a typical clinical picture and matching histopathology. In severe cases, there may be associated with mucous membrane involvement. CONCLUSION: Although ocular involvement has been reported in pityriasis lichenoides, this is the first report of conjunctival inflammatory nodules with secondary corneal ulceration as a part of the manifestations of the pityriasis lichenoides spectrum. Treatment with topical steroid drops was required to bring this condition under control.

Chronic granulomatous disease and peripheral ulcerative keratitis: a rare case of recurrent external ocular disease.

CLINICAL REPORT: We report a case of a 29-year-old lady, with known Chronic Granulomatous Disease, who presented with an acneiform scarring facial and trunk eruption and sore red eyes. Slitlamp examination showed limbal granulomas and adjacent peripheral ulcerative keratitis. DISCUSSION: The authors are considering the possible causes of the keratitis. As there were no signs of blepharitis at the time of initial presentation, the keratitis was most likely mediated by the adjacent limbal granuloma, and not due to Staphylococcal hypersensitivity. CONCLUSION: Although ocular involvement in CGD has been described before, this is the first article that describes limbal granulomata and peripheral ulcerative keratitis. Multidisciplinary management with longstanding oral antibiotic treatment, and topical combined antibiotic-steroid treatment were required to bring the condition under control.

Masquerade syndrome: T-cell prolymphocytic leukemia presenting as panuveitis.

PURPOSE: To report a case of T-cell prolymphocytic leukemia with panuveitis as the primary presenting feature. METHODS: Case report. RESULTS: A 46-year-old woman presented with pain and blurred vision in the right eye. She was found to have signs of panuveitis with a central exudative retinal detachment. Further investigations revealed that she was suffering from the rare T-cell prolymphocytic leukemia. Both systemic and ocular manifestations of the disease resolved after chemotherapy with Campath-IH antigen and as she went into complete remission. The exudative detachment settled, and visual acuity recovered to 20/20. CONCLUSION: This case illustrates that leukemias can present with primarily ocular findings, and the sudden appearance of a serous retinal detachment with inflammatory signs in an otherwise healthy person warrants a thorough systemic screening for an underlying malignancy.

Efficacy of Nd-YAG laser iridotomies in acute angle closure glaucoma.

Between September 1984 and April 1987 a total of 150 patients underwent Nd-YAG laser iridotomy procedures at the Bristol Eye Hospital. Forty of these patients (27%) were treated for acute angle closure glaucoma (AACG), and three of them (7%) suffered recurrent AACG. Sixteen patients who had been treated for AACG have been challenged by a pharmacological provocative test introduced by Mapstone, with a total of 23 eyes being tested. A negative result was obtained in all cases. Provocative testing is recommended to help identify those at risk of recurrent AACG.