Santosh Jajodia1
BACKGROUND Peripheral Ulcerative Keratitis (PUK) is a group of destructive, inflammatory disorders involving the peripheral cornea (3.5 mm – 4 mm) from the visual axis. It is associated with epithelial defect, stromal necrosis, and thinning leading to perforation and blindness. Invasion of microbial organism, immune complex deposition, trauma serves as an inflammatory stimulus in the peripheral cornea causing Peripheral Ulcerative Keratitis (PUK). PUK is rare. It is more common in people with collagen vascular disease. The combination of clinical data, and test results can lead to better diagnosis. Early diagnosis helps in preventing PUK related complications. METHODS 44 Eyes of 30 patients with PUK, who attended OPD of the Department of Ophthalmology at MKCG Medical College, Berhampur, in the state of Odisha, India were taken up for study. Their demographic profile & complaints were noted. A detailed history was taken, and a systemic evaluation with complete ocular examination was done along with microbiological and serological analysis. RESULTS The study showed that the prevalence of PUK is about 2.3 per 10000. (This study included both noninfectious and infectious causes). The age group commonly affected was middle aged individuals above the age of 30. Pain was more common in cases of Mooren’s ulcer and corneal phlycten. Unilateral involvement was found to be more common than bilateral. In this study, 72% of cases presenting with inflammatory peripheral corneal disease was of noninfectious etiology. The commonest noninfectious cause of PUK was catarrhal infiltrates associated with blepharitis in elderly age group. Collagen vascular diseases (RA & WG) presenting with PUK were more commonly seen in females. CONCLUSIONS PUK is a destructive, inflammatory disorder involving the peripheral cornea. The predominant cause of inflammation is an auto immune process which is either due to systemic or local factors. Infections do play a role in its etiopathogenesis. A detailed serological and microbiological assay is required before commencing treatment with anti-inflammatory and immunomodulator medications.
