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Congenital upper eyelid eversion complicated by corneal perforation.

H Al-Hussain·A A Al-Rajhi·S Al-Qahtani·D Meyer
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Corneal UlcerDown SyndromeEctropionFemaleHumansInfantKeratoplasty, PenetratingSkin TransplantationCase ReportsLetter

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H Al-Hussain, A A Al-Rajhi, S Al-Qahtani, D Meyer. 2005. Congenital upper eyelid eversion complicated by corneal perforation.. https://doi.org/10.1136/bjo.2004.053348

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Congenital tarsal kink is a rare condition. The folded edge of the upper tarsus, or the inturned lashes, may traumatize the cornea causing ulceration. We describe a case of unilateral upper eyelid horizontal tarsal kink associated with distichiasis and congenital corneal ulceration. Several different surgical treatment options have been previously alluded to in the literature including lamellar tarsoplasty, full-thickness eyelid fracture, and rotation and excision of the kink with tarsal reapposition. Repair by means of eyelid everting sutures via an anterior lamellar approach is presented as a novel technique to correct this congenital anomaly.

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PURPOSE: To report a case of coinfection of the human cornea by Stenotrophomonas maltophilia and yeast. METHODS: A 59-year-old woman presented with a corneal ulcer. The corneal lesion worsened suddenly after initial improvement with empirical antibiotic treatment. A culture revealed S. maltophilia. The keratitis rapidly progressed despite treatment with sensitivity-proven antibiotic agents. Eventually, the patient underwent therapeutic penetrating keratoplasty. RESULTS: Pathology of the cornea showed yeast forms and pseudohyphae scattered over the cornea. After surgery, the inflammation was controlled without any signs of recurrent infection. CONCLUSION: Coinfection of the cornea by S. maltophilia and yeast may occur in a susceptible cornea and may not be controlled by standard medical treatment.

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