Evaluating anterior corneal surface using Placido ring mires for irregular astigmatism in refractory corneal subepithelial infiltrates after adenoviral conjunctivitis.

Abstract

Background: Corneal subepithelial infiltrates (SEIs) are characteristic clinical findings of adenoviral keratoconjunctivitis (AKC). In eyes with SEIs, both corneal opacity and irregular astigmatism may interfere with vision. However, irregular astigmatism is often overlooked in patients with AKC. Here, we report a case of decreased vision due to irregular corneal surfaces detected by Placido ring mires in eyes with corneal SEIs after AKC.

Case presentation: An 8-year-old girl with decreased vision was referred to our clinic. She had been diagnosed with AKC two years prior by a different physician. Thereafter, she experienced recurring episodes of decreased vision, epiphora, and photophobia in both eyes. The symptoms persisted despite resolution of the corneal opacity with steroid eye drops. Despite mild corneal opacity, both eyes exhibited distorted Placido ring patterns on corneal topography. The decreased vision in both eyes was due to the irregular corneal surface caused by SEIs, rather than corneal opacity. Topical 0.1% tacrolimus eye drops were effective in treating corneal opacity and irregular corneal surfaces.

Conclusions: Our findings highlight that vision loss due to SEIs after AKC may stem from an irregular corneal surface regardless of corneal opacity severity, and the usefulness of a conventional and simple topography using Placido rings during treatment with 0.1% tacrolimus eye drops for SEIs in AKC.