Successful treatment of corneal perforation due to gonococcal keratoconjunctivitis with a combinations amniotic membrane transplantation and antibiotics

Abstract

AbstractPurpose: To present a case of gonococcal keratoconjunctivitis with corneal perforation as a rare case and its management.Methods: Case was reported from an outpatient clinic patient at Ophthalmology Department of Dr. Saiful Anwar General Hospital. The diagnosis was based on history taking, ophthalmological examinations and microbiological examination result.Results: A 19‐year‐old man complained of red, swollen, and painful eyes with sticky and copious discharge. The patient experienced clinical deterioration despite antibiotic treatment received at the previous eye clinic. There was a history of promiscuity and genital discharge 2 weeks before the eye symptoms. On eye examination, the visual acuity of the right eye was 1/60, and the left eye was 6/24. Both eyes showed conjunctival hyperemia and edema with purulent discharge. There was corneal perforation on the right eye sized 2.4 mm × 1.8 mm. Corneal erosion were noted on the left eye. Gram examination from conjunctiva swab of both eyes revealed intracellular Gram‐negative diplococci. The patient was hospitalized and received systemic antibiotics intravenous ceftriaxone, single dose oral azithromycin and topical moxifloxacin 0.5%. Patient also underwent amniotic membrane transplantation (AMT) in right eye due to small perforation. Improvement was noted as no discharge, closure of perforation, visual acuity of the right eye became 6/48, and the left eye became 6/6 at 1‐month follow‐up.Conclusions: Systemic and topical antibiotics with AMT effectively manage gonococcal keratoconjunctivitis with small corneal perforation.