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OPHTHALMIC IMAGE
Year : 2020  |  Volume : 68  |  Issue : 9  |  Page : 1970

Corneal melt in leptospirosis


Uveitis Service, Aravind Eye Hospital and PG Institute of Ophthalmology, Madurai, Tamil Nadu, India

Date of Web Publication20-Aug-2020

Correspondence Address:
Dr. S R Rathinam
Principal, Head of Uveitis Service, Aravind Eye Hospital and PG Institute of Ophthalmology, Anna Nagar, Madurai - 625 020, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_545_20

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How to cite this article:
Rathinam S R, Chidambaranathan GP. Corneal melt in leptospirosis. Indian J Ophthalmol 2020;68:1970

How to cite this URL:
Rathinam S R, Chidambaranathan GP. Corneal melt in leptospirosis. Indian J Ophthalmol [serial online] 2020 [cited 2020 Sep 28];68:1970. Available from: http://www.ijo.in/text.asp?2020/68/9/1970/292576



A 45-year-old male patient, a butcher by profession, presented to us with complaints of pain and defective vision in his right eye for one day. The patient gave the history of a splash of tissue fluid in his right eye while he was cutting a goat. Upon examination, his corrected vision in the right eye was 6/36 and the left was 6/6. The right eye showed stromal edema and descemet fold with 3+ flare cells and a 3-mm hypopyon [Figure 1]a An anterior chamber tap with subsequent silver methamine staining was positive for leptospirosis [Figure 1]b. Topical moxifloxacin eye drops and Tab. Doxycycline 100 mg once a day were started. However, over the next few days, the cornea melted with an iris prolapse through the wound [Figure 1]c and [Figure 1]d. Eventually the eye went into phthisis. Occupational exposures [1] and cell membrane injuries [2] are known in leptospirosis. However, iatrogenic moxifloxacin induced corneal melt should also be considered during differential diagnosis.
Figure 1: (a) Corneal edema with descemet folds, 3-mm hypopyon and subconjunctival hemorrhage one day after the splash of tissue fluid from the goat. (b) Hypopyon shows leptospire with the neutrophils stained using the silver impregnation method. Approximately, 25 leptospires were observed under the microscope with a maximum of eight leptospires per field (40×). *denotes leptospires and N denotes neutrophil. (c) Corneal melt on the third day. (d) Corneal perforation with iris prolapse on the fourth day

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.



 
  References Top

1.
Sturman RM, Laval J, Weil VJ. Leptospiral uveitis. Arch Ophthalmol 1959;61:633-9.  Back to cited text no. 1
    
2.
De Brito T, Silva AMGD, Abreu PAE. Pathology and pathogenesis of human leptospirosis: A commented review. Rev Inst Med Trop Sao Paulo 2018;60:e23.  Back to cited text no. 2
    


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