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Bilateral liquefactive corneal necrosis: a rare and devastating complication of vitamin A deficiency in the adult

机译:双侧液化角膜坏死:成年人难以造成的维生素缺乏的复杂性

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摘要

A 34year-old man presented with diminution of vision, pain and whitish opacity in both eyes (right eye followed by left eye) since 1 week. He is a known case of chronic alcoholic abuse. He had multiple episodes of haemoptysis in the past. On general physical examination, he was severely malnourished with multiple oral ulcers. Visual acuity at presentation was light perception in both eyes with projection of rays accurate in all quadrants. Slit-lamp biomicroscopy revealed bilateral total corneal melt with diffuse conjunctival congestion. Corneal scrapings and blood investigations were done and he was started on empirical topical and systemic therapy followed by surgical intervention, with large corneal grafts in both the eyes (right eye followed by left eye) with 1 day interval. The visual gain in both the eyes were 20/400 at first postoperative day. The right eye developed severe fibrinous reaction on the second postoperative day which resolved with topical antibiotics, topical steroids and systemic steroids. The patient was followed up via telemedicine (due to COVID-19 outbreak) and he is able to carry out his daily routine work independently.
机译:一周以来,一名34年的老人提出了愿景,痛苦和白色不透明度(右眼,然后左眼)自1周以来。他是一种已知的慢性酒精滥用的案例。他过去有多次血粪剧集。关于一般体检,他严重营养不良,具有多个口腔溃疡。呈现的视力是在所有象限中精确的光线精确的眼睛都在光照。狭缝灯生物显微镜透露双侧全角膜熔体与弥漫性结膜充血。角膜刮痧和血液调查已经完成,他开始在经验局部和全身疗法上,随后进行手术干预,在眼睛(右眼后面的左眼)中具有大的角膜移植物,具有1天的间隔。在术后一天,双眼的视觉增益为20/400。右眼在第二次术后日发育严重的纤维反应,这些日子用局部抗生素,局部类固醇和全身类固醇解决。患者通过远程医疗(由于Covid-19爆发)进行了跟进,他能够独立进行他的日常生活。

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