Case Report: Managing a case of Tubercular Phlycten presenting as Sterile Corneal Perforation

Abstract

A 22-year-old Indian male presented with a sterile perforation at 5 o’clock in the left eye, and a visual acuity of 20/80. A month prior to presentation, he had nodular lesion in lower part of left cornea and was undergoing medical management from a local ophthalmologist. After ocular and systemic examination, probable diagnosis of phlyctenular keratoconjunctivitis (PKC) was established. Since the perforation was large and not amenable to application of tissue adhesives, it was managed with a corneal patch graft. After investigations, we found that this was a case of latent tuberculosis infection. He was referred to physician and was started on appropriate anti-tubercular therapy. At the final follow-up, the perforation healed, and he regained a vision of 20/20. Even though perforation with tubercular PKC is a rare entity, this case highlights that timely diagnosis and multimodal intervention is the key to successful management.