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Hydroa vacciniforme (HV) is an unusual photosensitivity disease of unknown aetiology which starts in childhood and is characterised by vesiculopapular eruptions on the exposed area of the body.1,2 Ocular manifestations of this disease are uncommon but can include conjunctivitis, vesicular eruptions of the conjunctiva and cornea that resemble phylctenular keratoconjunctivitis,3 corneal infiltration with vascularisation,4 and keratouveitis.5,6 However, no cases of HV have been reported in the ophthalmic literature in over 40 years, and in contrast with previously reported cases, to our knowledge, this is the first case of a patient with HV who presented initially only with ocular findings.
A 6 year old Indian boy was referred to the Proctor Foundation with a 3 month history of recurrent, self resolving episodes of redness, pain, and photophobia in his right eye associated with a “bump” on his temporal conjunctiva. Aside from an episode of “cold sores” on his lips 2 weeks before his presentation, he had no cutaneous complaints. On examination, visual acuity was 20/20 right eye and 20/25 left eye. The conjunctiva of the right eye was injected temporally, and the inferotemporal cornea had a faint anterior and diffuse deep stromal haze with vessels, consistent with an interstitial keratitis. The patient was given a presumed diagnosis of phlyctenular keratoconjunctivitis and treated with topical corticosteroid drops. Three months later, his symptoms returned in association with a vesicular crusting reaction of his …
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