Phlyctenulosis

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Aetiology

  • Likely a hypersensitivity reaction to Staphylococcus antigens, possibly associated with Rosacea, Tuberculosis, or worm infestation

Clinical Presentation

  • Small, pink-white limbal nodule with intense localised hyperaemia on the conjunctiva or at the limbus
  • Limbal phlyctenule can spread to the cornea

Treatment

  • Topical steroids + antibiotic (e.g., Tobradex (tobramycin+dexamethasone) gtt 3x/day).
    • Consider higher dosed steroids depending on the findings
  • Additional lubricating therapy and treatment of blepharitis

Sources

  • EyeWiki Phlyctenular Keratoconjunctivitis
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8th Edition (2015)