Abstract
Purpose :
To describe six patients presenting with central or nasal paracentral sterile corneal melts in which dacryocystitis was felt to be a risk factor for keratolysis in all cases.
Methods :
The medical records of six patients presenting to the Bascom Palmer Eye Institute with non-infiltrated central or nasal paracentral corneal melts and concurrent dacryocystitis.
Results :
All patients presented with central or nasal epithelial defects, stromal ulceration, or corneal perforations. All corneal melts were focal and lacked a culture-positive stromal infiltrate. Dacryocystitis was a concurrent diagnosis in all cases. The cultures of the lacrimal sac drainage were positive for Staphylococcus aureus, Streptococcus sp., Pseudomonas aeruginosa, and Propionibacterium acnes. Three patients with corneal perforation required surgical management. The corneal pathology stabilized after treatment of the dacryocystitis.
Conclusions :
Nasal or paracentral corneal melts may be associated with an underlying chronic dacryocystitis, suggesting that inflammatory mediators and impaired tear outflow in the setting of bacterial dacryocystitis may create a favorable environment for keratolysis. Prompt management of the lacrimal drainage system infection can lead to stabilization or resolution of the keratolytic process.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.