A 22-year-old man with a history of atopy and vernal keratoconjunctivitis presented
for a nonhealing complete corneal epithelial defect of the right eye (Fig. A, B). Biomicroscopy was notable for giant papillae on everted lids (Fig. C). Infectious
etiologies were ruled out. The patient disclosed a 2-week history of daily topical
anaesthetics use. A diagnosis of severe vernal keratoconjunctivitis complicated by
anaesthetic abuse was made. Despite outpatient treatment, he presented 1 month later
with a dense sterile stromal infiltrate (Fig. D) owing to continued anaesthetic abuse
and persistent epithelial defect. He was admitted to our inpatient service for cessation
of topical anaesthetic use and pain management. His epithelial defect eventually healed
with diffuse stromal haze, neovascularization, and limbal stem cell deficiency.
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Publication history
Published online: May 24, 2020
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© 2020 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
