In an attempt to expand the knowledge of this condition of unknown etiology, we present 3 cases of linear interstitial keratitis. Case series (3 cases are presented) and literature review. [ncbi.nlm.nih.gov]

• Collapse

   blunted upper incisor teeth known as Hutchinson's teeth  inflammation of the cornea known as interstitial keratitis  deafness from auditory nerve disease  frontal bossing (prominence of the brow ridge)  saddle nose (collapse of the bony part of [slideshare.net]

• Localized Edema

   Tuberculous IK is generally unilateral  Inflammation may involve either the anterior or posterior stroma  Cellular infiltration is often peripheral or quadrantic and is followed by localized edema, and later stromal vascularization may occur with [slideshare.net]

• Notched Incisors

  incisors),  Keratitis  Deafness occurs in 63% of cases Treatment (with penicillin) before the development of late symptoms is essential 21.  Stromal Keratitis in Acquired Syphilis Onset  Keratitis is very uncommon in acquired syphilis  Exceptional [slideshare.net]

• Corneal Opacity

  METHODS: Five eyes of five patients with congenital syphilitic interstitial keratitis who underwent keratoplasty for corneal opacities and corneal edema were studied. [ncbi.nlm.nih.gov]

  For the past few years, the parents noted increased corneal opacity. Examination revealed opacity of the anterior stroma with ghost vessels. This is thought to be interstitial keratitis secondary to herpertic keratitis. [sarawakeyecare.com]

  Some corneal opacity usually remains, causing mild to moderate vision impairment. Corneal opacification and other typical findings on slit-lamp examination Serologic testing to determine etiology The specific etiology must be determined. [msdmanuals.com]

• Foreign Body Sensation

  A 45-year-old woman with healed syphilitic interstitial keratitis presented with decreased vision, foreign-body sensation of the right eye, and bilateral conjunctival injection. [ncbi.nlm.nih.gov]

  Patients tend to be more symptomatic if the lesions are corneal and may present with tearing, irritation, photophobia or foreign body sensation. [clspectrum.com]

  Presentation - redness, pain, photophobia, foreign body sensation and reduced visual acuity. There will usually be an epithelial defect the presence of white cell infiltrate oedema. [patient.info]

• Conjunctival Injection

  A 45-year-old woman with healed syphilitic interstitial keratitis presented with decreased vision, foreign-body sensation of the right eye, and bilateral conjunctival injection. [ncbi.nlm.nih.gov]

  Ocular signs usually begin with sectoral conjunctival injection followed by a subepithelial, peripheral keratitis. The interstitial keratitis which subsequently develops is described as anterior stromal or superficial. [eyewiki.aao.org]

  Patients may have an anterior chamber reaction, fine keratic precipitates and conjunctival injection. In the chronic phase, the vessels regress leaving remnants (ghost vessels). [clspectrum.com]

  Regarding the ocular surface, syphilis can cause conjunctivitis, 6 episcleritis or scleritis. 7,8 Interstitial keratitis (See Figure 1), often associated with conjunctival injection and anterior chamber inflammation, is a well-recognized manifestation [reviewofophthalmology.com]

• Frontal Bossing

   blunted upper incisor teeth known as Hutchinson's teeth  inflammation of the cornea known as interstitial keratitis  deafness from auditory nerve disease  frontal bossing (prominence of the brow ridge)  saddle nose (collapse of the bony part of [slideshare.net]

• Neck Stiffness

  stiffness and photophobia  Stage 3 (Late disseminated infection) Ocular inflammatory signs occur in this stage of the disease and include  Episcleritis  Keratitis  Uveitis  Vasculitis  Exudative retinal detachment  Endophthalmitis 47.  Although [slideshare.net]

• Excitement

  Later a small-scale fresh invasion by treponema or toxins excite the inflammation in the sensitized cornea. The inflammation is usually triggered by an injury or an operation on the eye. [ophthalmologylife.blogspot.com]

The patient underwent a systemic workup for interstitial keratitis. All results including RPR and MHA-TP were negative except for Lyme antibody titer (enzyme-linked immunosorbent assay [ELISA]) 178 U/ml (normal, 159 U/ml). [ncbi.nlm.nih.gov]

Treatment was changed from topical 0.5% cyclosporine to topical 0.1% tacrolimus combined with topical acyclovir and betamethasone. After 2 weeks of treatment with topical tacrolimus, the degree of stromal infiltrates decreased. [ncbi.nlm.nih.gov]

Treatment The treatment should include topical treatment for keratitis and systemic treatment for syphilis. 1. Local treatment. Topical corticosteroid drops e.g., dexamethasone 0.1% drops every 2-3 hours. [ophthalmologylife.blogspot.com]

Treatment & Management Treatment of interstitial keratitis depends on the specific underlying disorder. [emedicine.medscape.com]

The prognosis of this secondary glaucoma was very poor, although medical therapy was taken for the wide open angle type, and surgical therapy for the angle closure type. [ncbi.nlm.nih.gov]

The prognosis with early diagnosis and treatment is good There are different types of keratitis, which include: Amoebic Keratitis: It is often seen in those who wear contact lenses and is caused by Acanthamoeba, a free-living amoeba Fungal Keratitis caused [dovemed.com]

Prognosis Prognosis for interstitial keratitis is good if recognized and treated early before significant corneal scarring has occurred. [eyewiki.aao.org]

Outlook (Prognosis) Diagnosing and treating interstitial keratitis and its cause early can preserve the clear cornea and good vision. [ufhealth.org]

Linear interstitial keratitis is a rare clinical entity and its histopathologic etiology remains undetermined. [ncbi.nlm.nih.gov]

Bacterial etiologies: Syphilis, Lyme Disease, Tuberculosis, Leprosy, Brucellosis, Leptospirosis Viral etiologies: Herpesviridae - Herpes simplex, Herpes Zoster, Epstein- Barr. [eyewiki.aao.org]

Diagnosis: Cogan's Syndrome EPIDEMIOLOGY Predominantly young to middle aged adults Rare SIGNS Interstitial keratitis (limbal stromal opacity or edema, non-inflammed vascular loops in the mid-stroma) Other inflammation of the eye ( episcleritis, scleritis [webeye.ophth.uiowa.edu]

[…] sensorineural hearing loss Brain tumor (eg, meningioma) Ménière disease Infections Treponema pallidum HIV Vasculitis Microscopic polyangiitis Polyarteritis nodosa Granulomatosis with polyangiitis (GPA) Connective tissue diseases Rheumatoid arthritis Background Epidemiology [arupconsult.com]

Epidemiology Interstitial keratitis is generally seen in the context of syphilis and, less commonly, in the context of herpes and Cogan syndrome. [emedicine.medscape.com]

Abstract We studied four patients with the clinical entity of nonsyphilitic interstitial keratitis and vestibuloauditory symptoms to determine whether immunologic abnormalities play a role in its pathophysiology. [ncbi.nlm.nih.gov]

A discussion of the causes, pathophysiology, and treatment of interstitial keratitis is also undertaken. The differential diagnosis and appropriate laboratory tests for patients with interstitial keratitis is given. [morancore.utah.edu]

Pathophysiology The pathophysiology of interstitial keratitis is unknown, but varies significantly by eitology.The majority of bacterial and parasitic IK is a result of direct invasion of the corneal stroma and the host's allergic/ immune reaction to [eyewiki.aao.org]

Pathophysiology By definition, IK is a nonsuppurative inflammation, which is characterized by cellular infiltration of the corneal stroma. In general, no primary involvement of the corneal epithelium or endothelium occurs. [odlarmed.com]

[…] polyangiitis (GPA) Connective tissue diseases Rheumatoid arthritis Background Epidemiology Incidence – rare; 250 cases reported (Singer, 2015) Age – young adults in 20s-30s A few cases in children and adults 50 years Sex – M:F, equal Ethnicity – none reported Pathophysiology [arupconsult.com]

Prevention Prevention consists of avoiding the infection that causes interstitial keratitis. If you do get infected, get prompt and thorough treatment and follow-up. Images References Ginsberg SP. Corneal problems in systemic disease. [ufhealth.org]

SYSTEMIC - high doses of penicillin to prevent further development of lesions - systemic steroids can be given in refractory cases. 15. [slideshare.net]

Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization [books.google.de]