eMedicine Specialties > Ophthalmology > Cornea

Peripheral Ulcerative Keratitis: Follow-up

Author: Ellen N Yu, MD, Consulting Staff, Department of Ophthalmology, St Luke's Medical Center, Quezon City, Philippines
Coauthor(s): C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
Contributor Information and Disclosures

Updated: Dec 8, 2008

Follow-up

Further Outpatient Care

  • Continued, possibly lifelong, follow-up care is necessary even after complete resolution since relapses may occur. Furthermore, many patients may require prolonged systemic steroid, nonsteroidal anti-inflammatory, and/or chemotherapeutic medications for the systemic disease despite a quiet eye.

Complications

  • Ocular complications include corneal scarring and neovascularization with irregular astigmatism, corneal thinning and perforation, loss of vision, and even blindness.

Prognosis

  • In patients with collagen vascular diseases, PUK with necrotizing scleritis is associated with poor life expectancy because of the presence of subclinical systemic vasculitis.

Patient Education

  • Inform patients about both ocular and systemic components of the disease, treatment options, and possible complications. Emphasize lifelong follow-up care.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education article Corneal Ulcer.

Miscellaneous

Medicolegal Pitfalls

  • Error in diagnosis and treatment
  • Failure to explain course of the disease and possible complications
  • Failure to refer to proper specialists for systemic symptoms and medications
  • Failure to explain possible adverse effects of topical and systemic medications
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Lijing Yao, MD, to the development and writing of this article.



More on Peripheral Ulcerative Keratitis

Overview: Peripheral Ulcerative Keratitis
Differential Diagnoses & Workup: Peripheral Ulcerative Keratitis
Treatment & Medication: Peripheral Ulcerative Keratitis
Follow-up: Peripheral Ulcerative Keratitis
Multimedia: Peripheral Ulcerative Keratitis
References
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Further Reading

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Keywords

peripheral ulcerative keratitis, peripheral corneal ulceration, PUK, marginal corneal ulcer, corneal stroma, corneal perforation, rheumatoid arthritis, RA, vision loss, blindness

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Contributor Information and Disclosures

Author

Ellen N Yu, MD, Consulting Staff, Department of Ophthalmology, St Luke's Medical Center, Quezon City, Philippines
Ellen N Yu, MD is a member of the following medical societies: American Academy of Ophthalmology and Philippine Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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