Abstract

Peripheral ulcerative keratitis (PUK) occurs as a result of immune-mediated or inflammatory melting of the peripheral corneal stroma (keratolysis) due to an interplay between the anatomical and physiological characteristics of the peripheral cornea, extrinsic environmental factors and intrinsic host factors. PUK may occur in association with underlying ocular conditions such as bacterial, viral and fungal infections, ocular trauma, keratoconjunctivitis sicca, neurotrophic keratitis, Mooren's ulcer and other ectatic disorders. Systemic associations include infections, autoimmune diseases like Wegener's granulomatosis, rheumatoid arthritis, systemic lupus erythematosus, rosacea, inflammatory bowel disease and malignancy. The best corrected visual acuity (BCVA) was 6/60 and 6/9 in the right and left eye, respectively. He did not give any history of prior similar episodes. Progressive corneal thinning and impending corneal perforation are an important indication for emergency keratoplasty in patients with PUK.

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