|Year : 1974 | Volume
| Issue : 3 | Page : 31-32
SS Ray, A Thomas
Schell Eye Hospital, C.M.C. Vellore-632001, India
S S Ray
Schell Eye Hospital, C.M.C. Vellore-632001
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ray S S, Thomas A. Molluscum keratitis. Indian J Ophthalmol 1974;22:31-2
Molluscum contagiosum is one of the most easily overlooked causes of chronic unilateral conjunctivitis refractory to routine treatment. Although ocular molluscum contagiosum does not appear to be a common eye disease, it probably occurs more often than we realise. It can give rise to varieties of clinical findings. Generally a moderately severe follicular conjunctivitis occurs. We had six such cases with multiple lesions involving the lids with associated conjunctivitis. The present case is being reported as this is our first case of molluscum contagiosum with corneal involvement.
| Case Report|| |
A 12 year old girl attended our outpatient clinic with a history of redness of her left eye and difficulty in facing sun light for one month.
On examination the right eye was normal in all respects. Examination of the left eye showed three seperate round discrete masses, pale brown in colour, situated on the upper lid margin varying in size between 2 to 3 mms. All were umblicated and the consistancy was firm. No growth was seen in the lower lid. Upper palpebral conjunctiva showed fine follicles. On slit lamp examination cornea showed superficial punctate keratitis both in the upper and lower part divided by a clear band of cornea in the centre. There was no aqueous flare. Provisional diagnosis of molluscum contagiosum was made.
The masses were excised and the bases were cauterized with heat cautery. The eye was bandaged after applying antibiotic and atropine ointments.
The histopathological examination showed tissues with pigmented stratified squamous epithelium and marked acanthocytosis of the lining epithelium. The prickle cells of the epithelium contained large eosinophilic inclusion bodies. Diagnosis of molluscum contagiosum was confirmed.
Daily dressing with antibiotic ointment was done. Within a period of 15 days conjunctivitis healed and the corneal lesions cleared completely.
| Discussion|| |
Molluscum contagiosurn is classically described as a yellow pink raised umblicated tumour of the skin measuring an average 2 mm in diameter. It may be situated either on the lid margin or in the lid in close proximity of the palpebral aperture.
Molluscum contagiosum is universaly accepted as a virus disease but Van Rooyen and Rhodes  have pointed out that it could be due to fungus.
Desquammated virus material from the molluscum lid nodule is the causal factor producing the conjunctival and corneal inflammation. Secondary inflammation of the eye is believed to be a toxic reaction to desquammated virus material. In the conjunctiva it can produce a follicular conjunctivitis or a papillary hyperplasia simulating trachoma. The commonly found corneal lesion is a superficial punctate keratitis mostly involving the upper half of the cornea regardless of the location of the lid lesion but in our case superficial punctate lesions were involving both the upper and lower halves of the cornea. No pannus formation was noted which is a late manifestation of the disease. This case demonstrates the necessity of careful external examination in cases of chronic unilateral conjunctivitis and keratitis. The examination should include a thorough inspection of the lid margin, cilia roots and the skin of the eye lids, because a nodule in close proximity to the palpebral aperature may also cause ocular involvement. All suspicious lesions should be excised and sent for histopathological examination.
| Summary|| |
A case of chronic unilateral conjunctivitis with keratitis due to molluscum contagiosum has been presented. Local excision of the nodules and heat cautery helped in permanent cure of the eye inflammation.
| References|| |
Van Rooyen, C.F.
and Rhodes, Arch. J. (1950) "Molluscum Contagiosum in virus disease of man."
London, Milford, 121-120.
[Figure - 1], [Figure - 2]