DOI: 10.36347/sjmcr.2018.v06i04.012

Pages: 259-263

This case series report on three cases of adults presented with corneal melt secondary to multiple aetiologies and challenges in its management. Case 1 and 3 were a sero-positive rheumatoid arthritis (RA) and atypical painless Mooren’s ulcer (MU) respectively that presented with corneal perforation, while, case 2 was a unilateral MU patient with aggressive corneal melting. Case 2 and 3 had previous history of ocular surgery. All patients showed progressive corneal melting despite of intensive medical immunosuppressive therapy. Penetrating keratoplasty (PK) was performed for case 1 and lamellar keratoplasty for case 2 and 3. Post operatively, the visual acuity ranged from 1/60 to 6/18. Corneal melting is a vision threatening condition that usually has an underlying systemic aetiology. A systemic workup is crucial in its diagnosis and treatment. The rapid course of the disease and unpredicted response to treatment make every case a challenge in its management.