Brief report
Conjunctival ulceration following triamcinolone injection

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Abstract

Purpose

To report conjunctival ulceration as a complication of periocular triamcinolone acetonide injection.

Design

Interventional case series.

Methods

Conjunctival ulceration was found in three patients who had anterior subtenon’s or subconjunctival deposition of triamcinolone. Cultures from the ulcer edges were negative.

Results

Most of the triamcinolone extruded, and the conjunctival ulcers healed with minimal scarring.

Conclusions

Conjunctival ulceration was a potential complication of periocular triamcinolone injection in three patients who had anterior subtenon’s or subconjunctival deposition of the corticosteroid.

Section snippets

Case 1

A 37-year-old woman with recurrent acute iridocyclitis in the right eye was given a subconjunctival injection of 40 mg of triamcinolone in the upper temporal quadrant by her ophthalmologist. The patient was referred to our institute 5 days later when sloughing of the conjunctiva was noted at the injection site. Examination revealed a large oval area (8 mm × 7 mm) of bulbar conjunctival ulceration in the upper temporal quadrant, 1 mm behind the limbus (Figure 1). In the absence of the

Case 2

A 30-year-old woman presented with a history of pain, watering, discharge, and redness for 1 week following an injection in the right eye. An elliptical area (9 mm × 4 mm) of bulbar conjunctival ulcer with depot corticosteroid in its bed 1.5 mm from the limbus was present in the upper temporal quadrant (Figure 2). The patient had a best-corrected visual acuity of 20/30 and a mild iritis. The patient’s ophthalmologist was contacted, and we learned that he had given the patient an anterior

Case 3

A 35-year-old man presented with pain and watering in the right eye following an injection of triamcinolone in the upper fornix for pars planitis, elsewhere. There was congestion in the upper temporal quadrant, and a bulbar conjunctival ulcer (2 mm × 2 mm) was present in the fornix with triamcinolone extruding from it. Vision was 20/60, and mild vitreitis was present. The patient’s ophthalmologist was contacted; he had given the patient a posterior subtenon’s injection.

The intraocular pressure

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