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Corneal perforation after noncontact tonometry in patients with active recurrent herpes simplex keratitis: case report

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Abstract

Purpose

To report iatrogenic complications and to review the potential complications caused by noncontact tonometry (NCT) in related literature.

Methods

This case report describes two cases of active recurrent herpes simplex keratitis (HSK) on top of a thin corneal scar. The cornea was perforated by the air pulse from the NCT, resulting in an air bubble in the anterior chamber.

Results

Both patients were diagnosed with active recurrent necrotizing stromal HSK on top of a thinned corneal scar after previous therapeutic treatment involving tissue adhesive glue with a bandage contact lens (BCL) to treat a perforated cornea. During a follow-up visit, both patients reported similar symptoms of acute pain and fluid exuding from their eyes immediately after undergoing NCT. Slit-lamp examination revealed a perforated cornea with an intracameral air bubble. Treatment involved use of tissue adhesive glue and BCL in both cases.

Conclusion

NCT may not be sufficiently safe in patients with active infectious keratitis, particularly in cases where the cornea is relatively thin and necrotic.

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Acknowledgement

This study was presented in part as a poster presentation at the 5th Asia Cornea Society Meeting, Seoul, Korea (December 9–11, 2016).

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Authors and Affiliations

  1. Department of Ophthalmology, Chiang Mai University, Chiang Mai, 50200, Thailand

    Napaporn Tananuvat, Atitaya Apivatthakakul & Chulaluck Tangmonkongvoragul

Authors
  1. Napaporn Tananuvat
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  2. Atitaya Apivatthakakul
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  3. Chulaluck Tangmonkongvoragul
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Correspondence to Napaporn Tananuvat.

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Tananuvat, N., Apivatthakakul, A. & Tangmonkongvoragul, C. Corneal perforation after noncontact tonometry in patients with active recurrent herpes simplex keratitis: case report. Int Ophthalmol 39, 697–701 (2019). https://doi.org/10.1007/s10792-018-0854-x

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  • DOI: https://doi.org/10.1007/s10792-018-0854-x

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