A case of corneal abscess following self-medication with topical dermatologic corticosteroids in a child

Abstract

Topical dermatologic corticosteroids (TDC), while essential in treating skin conditions, can cause severe complications when misused, particularly in children. This case study reports a 7-year-old girl with a history of long-term self-medication with 0.05% betamethasone for dermatological lesions, resulting in iatrogenic Cushing's syndrome and a severe corneal abscess. The child presented with visual loss, corneal infiltrates, and hypopyon. Ocular and biochemical tests confirmed the diagnosis. The management included antifungal and antibacterial treatments, intrastromal voriconazole injection, and amniotic membrane grafting. TDC were gradually discontinued, and tacrolimus was used for skin symptoms. After 3 months, visual acuity improved to 3/10, with residual corneal opacity. This case emphasizes the dangers of prolonged TDC use without supervision and the need for early intervention in ocular complications.