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]

• Constitutional Symptom

  symptoms including fever, hearing loss, shortness of breath. [eyewiki.aao.org]

• Jaundice

  The fetal stigmata seen before the age of 2 years include eruptions characteristic of secondary syphilis, such as maculopapular rash and desquamating erythema of the palms and soles; hepatosplenomegaly; and jaundice. [dartmouth.edu]

• Ulcer

  H16.01 Central corneal ulcer H16.011 Central corneal ulcer, right eye H16.012 Central corneal ulcer, left eye H16.013 Central corneal ulcer, bilateral H16.019 Central corneal ulcer, unspecified eye H16.02 Ring corneal ulcer H16.021 Ring corneal ulcer [icd10coded.com]

  Ulcerative areas improved after treatment with 1 g of amphotericin B. [ncbi.nlm.nih.gov]

  General Pathology Intralamellar infiltration of lymphocytes with extensive neovascularization in the absence of overlying ulceration. [eyewiki.aao.org]

  On the other hand, noninfectious ulcerative keratitis can be related to a variety of systemic or local causes, predominantly of autoimmune origin. Keratitis pathogenesis infections ulcerative nonulcerative © 2001 Plenum Publishing Corporation [bioscirep.org]

• Skin Disease

  […] with the spirochete Borrelia burgdorferi via the Ixodes scapularis deer tick 46.  Signs of disease have been separated into three stages  Stage 1 (Early localisied infection) Flulike illness and the pathognomonic skin lesion Bull’s eye lesion, erythema [slideshare.net]

• Corneal Opacity

  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]

  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]

  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 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]

• Snow Blindness

  Photokeratitis — keratitis due to intense ultraviolet radiation exposure (e.g. snow blindness or welder 's arc eye.) [en.wikipedia.org]

  blindness Welders keratitis H16.131 Photokeratitis, right eye H16.132 Photokeratitis, left eye H16.133 Photokeratitis, bilateral H16.139 Photokeratitis, unspecified eye H16.14 Punctate keratitis H16.141 Punctate keratitis, right eye H16.142 Punctate [icd10coded.com]

  Ultraviolet light from sunlight (snow blindness), a tanning light or a welder's arc, contact-lens overwear, and chemical agents, either in liquid form splashed into the eye or in gases in the form of fumes can all result in noninfectious keratitis. [medicinenet.com]

• Irritability

  A patient with keratitis may wear a patch to protect the healing eye from bright light, foreign objects, the lid rubbing against the cornea, and other irritants. [encyclopedia.com]

  Mild irritation and a three-week history of reduced vision were the presenting symptoms of a 40-year-old black female. A 32-year-old black male presented with slight irritation of his right eye that had been present off and on for several months. [clspectrum.com]

  Prescription medication may ease pain, and wearing an eye patch can help reduce the risk of further injury or irritation. Treatment for infectious keratitis depends on the type of infection. [belmarrahealth.com]

  Lubricants reduce the redness and provide relief from the chronic irritation. [patient.info]

  The use of contact lenses increases the risk of developing keratitis, especially if hygiene is poor, improper solutions are used to store and clean the lenses, or if contact lenses are worn improperly or in the presence of persistent irritation. [medicinenet.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 & Management Treatment of interstitial keratitis depends on the specific underlying disorder. [emedicine.medscape.com]

Sometimes topical corticosteroids Keratitis may resolve with treatment of the underlying condition. Additional topical treatment with a corticosteroid, such as prednisolone 1% four times/day, is often advisable. [msdmanuals.com]

Therefore, treatment of the corneal manifestations may often occur independently or in parallel to the treatment of its underlying systemic cause. [eyewiki.aao.org]

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 The prognosis for interstitial keratitis is good if recognized and treated early before significant corneal scarring has occurred. [eyewiki.aao.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), HLTV-1, Mumps, Measles, Vaccinia, Variola Parasitic etiologies: Onchocerciasis [eyewiki.aao.org]

Corneal opacification and other typical findings on slit-lamp examination Serologic testing to determine etiology The specific etiology must be determined. [msdmanuals.com]

[…] 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]

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]

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]

(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]

Pathophysiology The pathophysiology of interstitial keratitis is unknown but varies significantly by etiology. [eyewiki.aao.org]

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]

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]

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

Prevention level General clinical use High-risk individual Primary prevention Provide prenatal screening and prevention practices for sexually transmitted diseases Treat expectant mothers with syphilis and provide accessible treatment for people with [slideshare.net]