A 37-year-old male with bilateral visual loss, itching and foreign body sensation.
History of Scopinaro's intervention three years ago, with several postoperative complications (tuberculous pulmonaryis, neuropathy of the extremities, anemia and gastrointestinal disorders).
The examination revealed mucocutaneous discomfort and general weakness.
Epithelial area showed lack of brightness in the ocular surface, decrease in meniscus and tear fracture time (BUTI) of 3 and 4 seconds in the right eye (OD) and in the left eye (left eye).
Bitöt staining was observed in the right limbus.
His visual acuity (VA) was counted fingers at 1 meter in the RE and 0.5 in the contralateral.
Schirmer's test was 5 mm in the right eye and 7 mm in the left eye.
Fluoroquinone treatment was started, followed by topical 0.1% (FML®, Allergan SA. Madrid, Spain) with partial remission without preservatives (Visfresh®, Allergan SA).
Autologous serum was achieved in 20% every 4 hours in both eyes, with gradual improvement.
At 4 months, epitheliopathy regressed almost completely, with a Schirmer test of 7 and 8 mmHg in RE and LE respectively and a final corrected VA of 0.7 in both eyes.
