Infectious Crystalline Keratopathy
Photographer: Antoinette Venckus, CRA; Photomicrographs by Nasreen Syed, MD
Posted February 25, 2019
This 73-year-old male patient presented to the Cornea service with a one-week history of right eye redness and pain. He had a remote history of open globe with multiple subsequent penetrating keratoplasties and a recent macula-involving retinal detachment all in the right eye with resulting hand motions vision. He was diagnosed with suture-related infectious crystalline keratopathy with associated epithelialized stromal melt. The dense crystals seen within the deep stroma represent arborizing aggregates of an infectious agent, often alpha-hemolytic streptococcus or Candida albicans, and often originating from a suture track. Microbial colonies proliferate within stromal lamellar spaces and are shielded by a biofilm . Corneal cultures are often negative. Lack of host inflammatory response may be due to chronic immunosuppression, tear film irregularity, or suture .
Please see related case for further information and discussion regarding treatment.
- Porter AJ, Lee GA, Jun AS. Infectious crystalline keratopathy. Surv Ophthalmol 2018;63(4):480-499. https://PubMed.gov/29097211. DOI: 10.1016/j.survophthal.2017.10.008
- Mannis MJ, Holland EJ. Cornea. Fourth edition. ed.
Contributor: Matt Ward, MD, The University of Iowa
Category: Cornea/External Eye Disease
Posted October 5, 2012
This an indolent corneal infection classically occuring in the absence of an epithelial defect in corneal transplants on chronic steroid therapy. It has a frost-like crystalline pattern. It is typically caused by alpha-hemolytic streptococcus species such as Viridans. In this case, this patient was on chronic mild steroid drops (fluormethalone) for treatment of severe, recalcitrant blepharitis and ocular surface disease. ICK is difficult to treat medically and may require debridement either by hand or with an excimer laser.
Contributor: Andrew Doan, MD, PhD, University of Iowa
Posted February 8, 2008
Infectious crystalline keratopathy in corneal transplant graft. Often strep viridans is the culprit.
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