Massive lipid keratopathy after Elizabethkingia meningosepticum keratitis

Abstract

To report the occurrence of massive lipid deposition in the cornea after Elizabethkingia meningoseptica keratitis. A 52-year-old female presented to the ophthalmology outpatient department of the Hong Kong Eye Hospital in January 2012 with complaints of pain, redness, watering and blurred vision in her left eye for 6 days. Past records showed that the patient underwent radiotherapy for mucoepidermoid carcinoma of the maxillary antrum which was later complicated by radiotherpay associated dry eye syndrome in her left eye. At the time of presentation, her best-corrected visual acuity was 0.7 OD and hand motions close to face OS. Slit lamp examination of the left eye showed a small infiltrate 1.4mm×1.2mm in size with an overlying epithelial defect. Elizabethkingia meningosepticum was isolated on broth. Good clinical response was observed with hourly 5% vancomycin eye drops. At the end of 8 weeks, slit lamp examination of the left eye revealed a corneal scar with mild lipid deposition at the site of previous corneal infiltrate. The lipid deposits increased tremendously over the next 4 weeks. The final visual acuity in the right eye dropped down to perception of light. The patient refused any further surgical intervention and is on regular follow-up in our clinic. Our case report highlights the occurrence of post-keratitis lipid keratopathy with E. meningosepticum.