Corneal ulcer as the first manifestation of HIV infection: a clinical case

Abstract

Background. Corneal ulcers are among the severe diseases that are difficult to treat. Most cases of corneal ulcers are caused by infectious etiology in the presence of predisposing risk factors, such as wearing contact lenses, eye injuries, chronic diseases of the accessory apparatus of the eye, dry eye syndrome. Of particular importance at present is the increase in cases of corneal ulcers among HIV-infected patients. HIV leads to thinning of the cornea and the formation of an ulcerative defect, and systemic immunodeficiency contributes to the rapid addition of a secondary infection.

The aim. Description of a clinical case of a corneal ulcer with perforation as the first sign of HIV infection.

Materials and methods. To assess the clinical case, we used a retrospective analysis of the patient’s medical history and the results of laboratory research methods.

Results. This clinical example demonstrates the possibility of the occurrence of a corneal ulcer with perforation against the background of immunodeficiency caused by HIV-positive status. The patient came with a corneal ulcer complicated by perforation and fibrinous-plastic iridocyclitis. The localization of the ulcer at the limbus, the absence of loose infiltration of the edges, and high visual functions determined the gentlest surgical tactics in the form of suturing the ulcer defect by applying corneo-limbal sutures without separating the conjunctiva.

Conclusion. Timely drug therapy and surgical treatment led to the closure of the ulcer defect and restoration of visual functions. The postoperative course was smooth and had no peculiarities, despite the HIV-positive status of the patient and the lack of therapy for the underlying disease, since a corneal ulcer with perforation was the first manifest sign that forced the patient to seek medical help.