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OPHTHALMIC IMAGE
Year : 2019  |  Volume : 67  |  Issue : 7  |  Page : 1176

Molluscum-related keratoconjunctivitis


Cornea and Anterior Segment Sevices, Dr Shroff Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, New Delhi, India

Date of Web Publication25-Jun-2019

Correspondence Address:
Dr. Manisha Singh
Dr Shroff Charity Eye Hospital, 5027, Kedarnath Marg, Daryaganj, New Delhi - 110 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1808_18

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How to cite this article:
Singh M, Acharya M, Gandhi A, Prakash U. Molluscum-related keratoconjunctivitis. Indian J Ophthalmol 2019;67:1176

How to cite this URL:
Singh M, Acharya M, Gandhi A, Prakash U. Molluscum-related keratoconjunctivitis. Indian J Ophthalmol [serial online] 2019 [cited 2019 Oct 16];67:1176. Available from: http://www.ijo.in/text.asp?2019/67/7/1176/261020



A 24-year-old male presented with recurrent history of redness, watering photophobia, and pain in his left eye which resolved on topical antibiotic and steroids temporarily. There was no alleged history of foreign body or trauma. Visual acuity in the right eye was 20/20 and left eye was 20/80. Slit lamp bio-microscopy of the left eye revealed follicular conjunctivitis with mucopurulent discharge and a skin-colored, dome-shaped papule with waxy, curd-like core and an umbilicated center at the upper lid margin [Figure 1]a. The cornea in the upper one-third showed an epithelial defect with subepithelial and anterior stromal infiltration with pannus and few satellite lesions on the temporal aspect [Figure 1]b. Excision biopsy with cryotherapy of the lesion was done and sent for histopathological examination. This led to prompt resolution of symptoms and signs of the patient [Figure 1]c. Histopathological analysis of the specimen demonstrated epidermal hyperplasia producing a crater filled with molluscum bodies [Figure 1]d. Blood investigation was done to rule out any immunosuppression. This case emphasizes the fact that ocular molluscum contagiosum is often overlooked as a cause of chronic conjunctivitis.[1] Follicular conjunctivitis, subepithelial infiltration, and corneal pannus are due to hypersensitivity reaction from viral proteins shed by skin.[2]
Figure 1: (a) Slit lamp photograph of the everted lid margin of the left eye of patient showing follicular conjunctivitis, lid margin showing umbilicated skin colored dome-shaped lesion suggestive of molluscum. (b) Slit lamp photomicrograph showing marginal keratitis with pannus superiorly and few satellite lesions at the temporal aspect of the cornea. (c) Slit lamp picture showing healed marginal keratitis post excision of the molluscum lesion. (d) Histopathology section (20×) with hematoxylin stain showing epidermal hyperplasia and molluscum bodies (large cells with cytoplasmic eosinophilic inclusion bodies)

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Molluscum contagiosum lid lesion varies in appearance and may resemble verruca, sebaceous cyst, milium, or fibroma. Lesion can be at the lid margin, some distance from ciliary margin and in the folds of the upper lid. Careful lid examination is necessary.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that their name and initial will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Balakrishnan E. Molluscum contagiosum conjunctivitis. Indian J Ophthalmol 1964;12:173-5.  Back to cited text no. 1
  [Full text]  
2.
Schornack MM, Siemsen DW, Bradley EA. Ocular manifestations of molluscum contagiosum. Clin Exp Optom 2006;89:390-3.  Back to cited text no. 2
    


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