Keratitis Due to Severe Sinonasal Disease with Underlying Granulomatosis with Polyangiitis

A young patient with no known prior medical history presents with decreased vision and pain in the right eye. On presentation, patient’s exam was notable for visual acuity of 20/150 in the right eye and 20/20 in the left eye. Intraocular pressure was 14 and 16 in the right and left eye, respectively. Initial slit lamp exam was remarkable for diffuse corneal haze and an inferonasal epithelial defect with an infiltrate that responded poorly to topical antibiotics. Subsequent cultures, imaging and laboratory findings found infectious keratitis in setting of extensive sinonasal disease and ANCA positivity suggestive of granulomatosis with polyangiitis. Patient was managed with IV antibiotics and systemic steroids with improvement.

Presentation Date: 08/17/2023

Issue Date: 09/01/2023