A 25-year-old woman presents with bilateral corneal stromal haze and deep vascularisation with a ground-glass appearance, first noticed in childhood. She also has sensorineural hearing loss and peg-shaped notched incisors. What is the most likely aetiology of the corneal findings?
- A Herpes simplex stromal keratitis
- B Stromal dystrophy (macular dystrophy)
- C Congenital syphilis (interstitial keratitis) ✓
- D Cogan's syndrome
Correct answer: C. Congenital syphilis (interstitial keratitis)
Explanation
Hutchinson's triad (interstitial keratitis, sensorineural deafness, notched incisors) is pathognomonic for late congenital syphilis. Interstitial keratitis presents with bilateral stromal deep vascularisation and haze. Herpes simplex is usually unilateral and recurrent. Macular dystrophy lacks vascularisation. Cogan's syndrome involves vestibuloauditory symptoms without dental abnormalities.
Reference: Basic and Clinical Science Course, Section 8: External Disease and Cornea, AAO 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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