This 20 year old male was seen on call for redness and photophobia of the left eye. On examination, three distinct limbal phlyctenules were visible (in photographs, they are stained with fluorescein). He was treated with topical steroids, lid hygiene scrubs, and antibiotic ointment to the eye and eyelid margin. When he returned two weeks later, the phlyctenules had resolved in the left eye.
Phlyctenulosis is the result of a hypersensitivity to microbial antigens. In the United States, Staphylococcus aureus is the most common organism. Phylctenulosis can also occur in tuberculosis endemic areas. Management of phlyctenular conjunctivitis requires aggressive lid hygiene for blepharitis along with topical steroids and often times, antibiotics.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
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