A case of intractable recurrent corneal erosion caused by Munchausen syndrome

Abstract

Object: We report a case of intractable recurrent corneal erosion that was unresponsive to any medication, but was cured by psychiatric care after diagnosis of Munchausen syndrome. Case: The patient, a 35-year-old female who developed pain in her left eye in July, 20 XX, was diagnosed with epidemic keratoconjunctivitis at the hospital where she worked as a nurse. Despite medication, the eye condition gradually worsened. After undergoing examination at many medical institutions, she came to our hospital on October 6, 20 XX. Her left eye manifested superficial punctate keratitis, then exhibited recurring corneal erosion. The eye condition was intractable, total corneal epithelial defect ultimately occurring on December 30. Subsequently, a bottle of hydrochloric acid oxybuprocaine eye drops was found under her pillow. We therefore suspected that the corneal erosion was due to self-inflicted injury. She consulted a psychiatrist, and was diagnosed with Munchausen syndrome. After about 2 months of therapy in which she was prevented from touching the eye (eye patch etc.), her eye condition improved. Conclusion: This case was not diagnosed as Munchausen syndrome for 5 months. In cases of intractable corneal erosion, the possibility of self-inflicted injury should be considered. Nippon Ganka Gakkai Zasshi