Corneal Perforation

Corneal perforation in a patient with severe dry eye syndrome secondary to rheumatoid disease was treated with cyanoacrylate tissue adhesive covered by a soft bandage contact lens. 

Can be caused by:

  • Progressive corneal thinning due to ectatic degeneration, Terrien's degeneration, infections, or immune-related diseases such as in Mooren's ulcer and rheumatoid disease
  • Trauma
  • Iatrogenic during ocular surgery such as astigmatic or radial keratotomy

Management:

  • Careful examination of other ocular structures involvement in cases of trauma.
  • Prophylactic antibiotics.
  • Soft bandage contact lens may be used for small perforations.
  • Surgical management:
    • Wound suturing.
    • Cyanoacrylate tissue adhesive application, protected by a soft bandage contact lens.
    • Penetrating pr tectonic keratoplasty.