Atypical Presentation of Herpes Stromal Keratitis in a Contact Lens Wearer.

Abstract

This article describes the case of a 21-year-old female habitual contact lens wearer who complained of left eye pain, redness, and decreased vision for one week. When a ring-shaped corneal infiltration indicative of an Acanthamoeba infection was discovered, standard anti-amoebic topical therapy with polyhexamethylene biguanide and chlorhexidine was commenced. However, her keratitis worsened. At the same time, corneal scraping revealed no pathogens. An anterior chamber examination revealed a loss of corneal sensation, and a positive herpes simplex virus (HSV) immunoglobulin G serology test indicated HSV keratitis. She was eventually treated with oral anti-viral medication and recovered completely. Her case was unusual, as she had a history of contact lens use, painful corneal ulceration, and the development of Acanthamoeba keratitis-like corneal ring infiltration. This case also reinforces the various manifestations of HSV keratitis, which lead to delayed diagnosis and treatment.

• Authors: Ruknesvary Subramaniam, Khairy Shamel Sonny Teo, Julieana Muhammed
• Journal: Cureus (Cureus) Vol. 15 Issue 5 Pg. e38438 (May 2023) ISSN: 2168-8184 [Print] United States
• PMID: 37273371 (Publication Type: Case Reports)
• Copyright: Copyright © 2023, Subramaniam et al.