Rare cases of corneal scar management after ocular trauma with 0.03% flurbiprofen and 0.5% loteprednol etabonate.

Abstract

Background: Ocular trauma has a wide variety of presentation. The most common cause of loss of vision after ocular trauma treatment is corneal opacity in the visual axis. The following two cases illustrate medical management of scar and significant improvement in visual acuity after scar management with topical, Loteprednol etabonate ophthalmic suspension 0.5% w/v and Flurbiprofen Sodium ophthalmic solution 0.03%. Case presentation, treatment and interventions: These two young male adults of ocular trauma where after initial treatment, first a case of penetrating injury right eye and the second case of blunt trauma with a vegetative foreign body causing fungal keratitis, have been described. The first case is of a young male presenting with penetrating injury with corneal laceration, he was treated with surgery. The second case is a case of vegetative injury (blunt trauma) and diagnosed as fungal keratitis and treated with antifungals, cycloplegics and antibiotics. After receiving the initial treatment successfully, both cases finally presented with central corneal scar leading to visual impairment. Treatment of central corneal scar: The corneal scar has been treated with topical 0.03%flurbiprofen and 0.5% loteprednol in tapering doses have shown significant improvement of vision as the scar has shown significant thinning. Aim of submitting this case report is to highlight the importance of treatment of corneal scar with a combination of both these drugs. Using this very simple method of treating the cases of central corneal scar a near-complete removal of the scar with good visual recovery could be attained. This is the first time such treatment of corneal scar has been reported using a combination of topical flurbiprofen and loteprednol. Conclusion: The early treatment with the above two easily available topical medication has been beneficial in maintaining the transparency of the cornea. These are just case reports and a more detailed study will be required to establish the utility of such regime in all cases of the central corneal scar.