Abstract

A 15-year-old boy presented with acute onset redness and visual acuity of 20/200 in both eyes. On slit-lamp examination, he had a bilateral corneal epithelial defect, diffuse anterior stromal keratitis (Fig A, B), with few keratic precipitates. Systemic examination at the next visit revealed a tender left knee with effusion (Fig D) and Achilles’ enthesitis. The immunology panel showed increased erythrocyte sedimentation rate and C-reactive protein, positive human leucocyte antigen (HLA)-B27, negative rheumatoid factor, normal angiotensin-converting enzyme levels, and chest X-ray.

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