Peripheral ulcerative keratitis as the initial presentation of rheumatoid arthritis

Nadir Ali Mohamed ALI, Ruben MATHEW, Nayan JOSHI

Department of Ophthalmology, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam 

ABSTRACT

Rheumatoid arthritis is a chronic auto-immune disease that leads to persistent symmetrical polyarthritis mainly affecting the hands and feet. Significant extra-articular involvements can occur including the eyes. However, most extra-articular manifestations usually occur in the presence of joints changes or symptoms. We report an interesting case of a 62-year-old Malay lady who was referred severe ocular presentation, peripheral ulcerative keratitis that led to the diagnosis of rheumatoid arthritis. Interestingly, she had typical changes of rheumatoid arthritis in the hand but was not troubled by them.

Keywords: Cataract, hypopyon, peripheral ulcerative keratitis, rheumatoid arthritis

Correspondence author: Nadir Ali Mohamed ALI, Department of Ophthalmology, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam. E mail: nadiramali@hotmail.com

Brunei Int Med J. 2012; 8 (6): 353-357