再発を繰り返し短期間で重症化した束状角膜炎の1例

A case of recurrent fascicular keratitis with rapid exacerbation

　9歳女児が6か月前からの再発性角膜病変で受診した。3歳の頃から九州に帰省するたびに結膜が充血し，ハウスダストなどに過敏であった。矯正視力は右1.0，左0.8で，左眼に球結膜充血，角膜潰瘍，束状の角膜浸潤があった。左眼瞼縁にマイボーム腺梗塞，両眼瞼結膜に乳頭増殖があった。左眼の束状角膜炎と両眼のアレルギー性結膜炎と診断した。抗菌薬と副腎皮質ステロイド薬の点眼で，4日後に角膜潰瘍が消失し，結膜炎が3か月後に軽症化した。慢性アレルギー性結膜炎が束状角膜炎の再発と悪化に関与していたと推定した。

A 9-year-old girl presented with recurrent corneal lesion in her left eye since 6months before. She had had repeated episodes of conjunctival irritation when travelling since the age of 3 years. She had been found allergic against house dust. Her corrected visual acuity was 1.0 right and 0.8 left. Her right eye showed hyperemia of bulbar conjunctiva,corneal ulcer,and fascicular corneal infiltration. Infarct of meibomian glands was present in the left lid margin. Both eyes showed papillary hypertrophy in the palpebral conjunctiva. We diagnosed her with fascicular keratitis in the left eye and allergic conjunctivitis in both eyes. Topical antibiotics and corticosteroid induced cure of corneal ulcer after 4 days. Conjunctivitis improved after 3months. It appears that presence of chronic allergic conjunctivitis facilitated recurrence and exacerbation of fascicular keratitis.