A 28-year-old woman presents with bilateral non-ulcerative stromal corneal infiltration with intact overlying epithelium, accompanied by progressive sensorineural hearing loss, tinnitus, and vertigo. The most likely diagnosis is:

• A Congenital syphilitic interstitial keratitis
• B Lyme disease keratitis
• C Herpes simplex disciform keratitis
• D Cogan syndrome ✓

Explanation

Cogan syndrome is an autoimmune vasculitis characterised by the triad of interstitial keratitis, vestibular dysfunction, and sensorineural hearing loss in a young adult. Congenital syphilis also causes interstitial keratitis with salmon patch and ghost vessels, but it begins in childhood and lacks acute vestibuloauditory deterioration. Disciform keratitis is unilateral, endothelial, and unrelated to hearing loss.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.