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Phlyctenular Keratoconjunctivitis

(Phlyctenular Conjunctivitis; Phlyctenulosis)

By

Melvin I. Roat

, MD, FACS, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision May 2020| Content last modified May 2020
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NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
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Topic Resources

Phlyctenular keratoconjunctivitis is an eye disorder that involves an immune reaction of the cornea (the clear layer in front of the iris and pupil) and conjunctiva (the membrane that lines the eyelids and covers the white of the eye) to bacteria.

  • Small, yellow-gray, raised bumps form on the eye.

  • Common symptoms are redness of the eye, blurred vision, sensitivity to bright light, a sensation of a foreign object trapped in the eye, and sometimes visible flakes of dead skin at the edges of the eyelids.

  • Doctors diagnose phlyctenular keratoconjunctivitis based on the eye's appearance.

  • Treatment is with eye drops or eyelid scrubs.

An Inside Look at the Eye

An Inside Look at the Eye

Phlyctenular keratoconjunctivitis is not an infection. It is an immune reaction to bacteria that are on or around the eyes. Some of the bacteria that trigger this disorder are staphylococci, and rarely, tuberculosis, and Chlamydia. This disorder is more common among children.

Symptoms

Small, yellow-gray, raised bumps (called phlyctenules) appear at the limbus (the area where the conjunctiva attaches to the cornea), on the cornea, or on the conjunctiva. The bumps last for several days to 2 weeks. On the conjunctiva, these bumps become open sores (ulcers) but heal without a scar. When the cornea is affected, severe tearing, photophobia (pain when light is shined into the eye), blurred vision, aching, and a feeling like a foreign object is in the eye (foreign body sensation) may be noticeable. Many people also have redness of the eye, blurred vision, increased sensitivity to bright light, a sensation of a foreign object trapped in the eye, and sometimes visible flakes of dead skin at the edges of the eyelids (seborrheic blepharitis).

People who have frequent recurrences may develop cloudy corneas, and tiny blood vessels may grow across their corneas. Their vision may become impaired.

Diagnosis

  • A doctor's evaluation of the eyes

The diagnosis of phlyctenular keratoconjunctivitis is based on the typical appearance of the eyes.

Doctors may test some people for tuberculosis.

Treatment

  • Corticosteroid/antibiotic eye drops

  • For seborrheic blepharitis, eyelid scrubs

People who do not have tuberculosis are given eye drops that contain a combination of corticosteroids and antibiotics.

People who have blepharitis caused by the skin condition seborrheic dermatitis (seborrheic blepharitis) can gently scrub the edges of the eyelids to help prevent the disorder from coming back (see Treatment of Blepharitis).

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
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