A 25-year-old man develops bilateral non-ulcerative interstitial keratitis together with acute vertigo, tinnitus, and progressive sensorineural hearing loss. Syphilis serology is negative and there are no oral, genital, or skin lesions. Urgent systemic immunosuppression is indicated mainly because of the risk of which complication?

• A Permanent profound deafness ✓
• B Corneal perforation
• C Secondary glaucoma
• D Retinal detachment

Explanation

This is Cogan syndrome, an autoimmune vasculitis pairing interstitial keratitis with Meniere-like vestibuloauditory dysfunction. The feared outcome is irreversible sensorineural deafness, which develops in a large proportion of untreated patients, hence early systemic corticosteroids. The corneal disease itself rarely perforates, so option B is the attractive but incorrect distractor.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.