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The Merck Manual--Second Home Edition logo
 
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Chapter 230. Corneal Disorders
Topics: Introduction | Superficial Punctate Keratitis | Corneal Ulcer | Keratoconjunctivitis Sicca | Keratomalacia | Herpes Simplex Keratitis | Herpes Zoster Ophthalmicus | Peripheral Ulcerative Keratitis | Keratoconus | Bullous Keratopathy
 
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Peripheral Ulcerative Keratitis

Peripheral ulcerative keratitis is inflammation and ulceration of the cornea that often occurs in people who have connective tissue diseases such as rheumatoid arthritis.

Peripheral ulcerative keratitis is probably caused by an autoimmune reaction (see Section 16, Chapter 186). Blurred vision, increased sensitivity to bright light, and a sensation of a foreign object trapped in the eye develop. The ulcer is located in the periphery of the cornea and is usually oval in shape.

Of the people who have rheumatoid arthritis and peripheral ulcerative keratitis, about 40% die (mostly due to a heart attack) within 10 years of developing peripheral ulcerative keratitis unless they are treated. Treatment with drugs that suppress the immune system, such as cyclophosphamide, reduces the death rate to about 8% in 10 years.

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