Corneal Melting in Undiagnosed Goujerot Sjogren’s Syndrome: A Case Report

Keratolysis or corneal melting is a very rare situation that might occur in different inflammatory systemic diseases such as Sjogren syndrome. In the case of sterile corneal ulcers, characterized by the absence of ocular inflammation, the optimal treatment has not yet been established. We report the case of a unilateral aseptic keratolysis revealing primitive Sjogren guzzler syndrome and having responded well to the treatment. Clinical case: a 56-year-old woman who presented with a notion of inflammatory polyarthralgia for 4 years with self-medication by oral non-steroidal anti-inflammatory drugs NSAID presented a month before her first examination, a reduced visual acuity with foreign body sensation in both eyes. After a month of ophthalmic examination for a corneal ulcer, the visual acuity dropped to HM, and the examination found a corneal perforation measuring less than 1 mm with a positive spontaneous seidel and an athalamia. A treatment with cyanoacrylate glue was performed along with medical treatment. A labial biopsy performed found a lymphoplasmacytic infiltration of the exocrine gland in favor of a primitive Gougerot Sjogren syndrome. Gougerot-Sjögren syndrome is a systemic autoimmune disease characterized by damage to the exocrine glands, in particular the lacrimal and salivary glands. The treatment of corneal perforations is based on different choices such as cyanoacrylate glue, amniotic graft, conjunctival recovery, and keratoplasty.