Disciform keratitis is usually attributed to reactivation of herpes simplex virus in previously infected eyes with an autoimmune component; hence, the concurrent usage of topical steroids as stipulated in the Herpetic Eye Diseases Study.1
It has been reported as an uncommon occurrence in eyes after surgery such as Lasik.2
Herpetic stromal keratitis is a potentially blinding corneal disease.3
Disciform disease is primarily an inflammatory reaction within the endothelium with endothelitis and only secondary stromal oedema in the absence of stromal inflammation or neovascularisation.3
Hence, the presence of a sticky inflamed endothelium, which promotes the adhesion of emulsified oil. Emulsified silicone oil in the anterior chamber is a common finding in silicone-filled eyes.
To our best knowledge, this report is the first to document emulsified oil adherent to an area of disciform keratitis in a silicone oil-filled eye.
- Adherence of emulsified oil to a specific area of the endothelium is a useful marker of inflammation in the corneal segment.
- Herpes simplex viral keratitis may occur in healthy individuals with previous exposure to the virus, particularly in eyes that have undergone previous intraocular surgery or insults such as repeat vitrectomies.
- Disciform keratitis in silicone-filled eyes should be treated with conventional topical anti-virals and steroids to prevent further adhesion of the oil to the cornea, which may promote corneal decompensation.