Phlyctenular keratoconjunctivitis

Phlyctenular Keratoconjunctivitis is a type of eye disease characterized by the formation of small, raised lesions, known as phlyctenules, on the cornea and conjunctiva of the eye. This condition is primarily an immune response to various antigens, most commonly related to tuberculosis, staphylococcal, or chlamydial infections. It is more prevalent in children and young adults and can lead to discomfort, visual impairment, and in severe cases, corneal scarring.

Causes and Risk Factors

Phlyctenular keratoconjunctivitis is caused by a hypersensitivity reaction to bacterial proteins. The most common antigens associated with this condition include:

• Mycobacterium tuberculosis, the bacterium responsible for tuberculosis
• Staphylococcus aureus, a common cause of skin infections
• Chlamydia trachomatis, which causes trachoma and chlamydial conjunctivitis

Environmental factors and poor hygiene can also increase the risk of developing phlyctenular keratoconjunctivitis, especially in areas with high prevalence of tuberculosis or where access to clean water and sanitation is limited.

Symptoms

Symptoms of phlyctenular keratoconjunctivitis include:

• Redness and irritation of the eye
• Sensitivity to light (photophobia)
• Tearing
• Formation of small, raised bumps (phlyctenules) on the cornea or conjunctiva
• Blurred vision if the cornea is affected

Diagnosis

Diagnosis of phlyctenular keratoconjunctivitis involves a comprehensive eye examination. A healthcare provider may also recommend:

• Slit lamp examination to closely observe the phlyctenules
• Skin tests for tuberculosis, such as the Mantoux test
• Blood tests to identify underlying bacterial infections
• Swab tests from the conjunctiva to detect bacterial or chlamydial antigens

Treatment

Treatment of phlyctenular keratoconjunctivitis focuses on addressing the underlying infection and managing symptoms. Options include:

• Topical antibiotics for bacterial infections
• Anti-tuberculosis medication if a tuberculosis infection is identified
• Steroid eye drops to reduce inflammation
• Artificial tears to alleviate discomfort

In cases where corneal scarring occurs, corneal transplantation may be considered to restore vision.

Prevention

Preventive measures for phlyctenular keratoconjunctivitis include:

• Timely treatment of bacterial infections
• Vaccination against tuberculosis in high-risk areas
• Maintaining good eye hygiene
• Avoiding contact with individuals who have active eye infections

See Also

• Conjunctivitis
• Keratitis
• Tuberculosis
• Staphylococcal infections
• Chlamydial infections