Abstract

In the period of 2012-2022, 53 patients (46 bilateral and 7 monolateral) were diagnosed with interstitial keratitis and treated at the Cornea-Uveitis department of the Ophthalmological Center after S.V. Malayan. 45 cases were herpetic in origin, 2 cases were associated with the syphilis, 1 case - with tuberculosis, 1 case - with sarcoidosis, 1 case - with Epstein-Barr virus, 1 case - with rosacea, and 2 cases - with the Cogan’s syndrome. The Cogan’s syndrome is a rare autoimmune disease. A 56-year-old female was admitted to the Ophthalmological Center after S.V. Malayan. She was complaining about photophobia, lacrimation, and blurred vision in both eyes. The slit lamp examination revealed bilateral interstitial corneal infiltrates associated with deep stromal corneal vascularization. Laboratory examinations of antibodies against Herpes virus 1,2, Varicella Zoster virus, Epstein-Barr virus, Hepatitis virus B and C, HIV, and syphilis were negative, and the chest X-ray was normal. Taking into consideration the patient’s history of problems with hearing, the Cogan’s syndrome was suspected. The patient was referred to otorhinolaryngological examination, which revealed bilateral sensorineural hearing loss. Thus, the patient was diagnosed with the Cogan’s syndrome and systemic corticosteroid treatment was initiated. The patient was also prescribed topical steroids every 2 hours and artificial tears QID. Topical steroids were reduced during two months. An early diagnosis is essential to initiate early treatment to prevent damage to the eye and ear, as well as to prevent systemic complications.

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