Nummular keratitis is a feature of viral

keratoconjunctivitis Keratoconjunctivitis is inflammation ("-itis") of the cornea and conjunctiva. When only the cornea is inflamed, it is called ''keratitis''; when only the conjunctiva is inflamed, it is called ''conjunctivitis''. Causes There are several potentia ...

. It is a common feature of adenoviral keratoconjunctivitis (an ocular

adenovirus Adenoviruses (members of the family ''Adenoviridae'') are medium-sized (90–100 nm), nonenveloped (without an outer lipid bilayer) viruses with an icosahedral nucleocapsid containing a double-stranded DNA genome. Their name derives from the ...

infection), as well as approximately 1/3rd of cases of

Herpes Zoster Ophthalmicus Herpes zoster ophthalmicus (HZO), also known as ophthalmic zoster, is shingles involving the eye or the surrounding area. Common signs include a rash of the forehead with swelling of the eyelid. There may also be eye pain and redness, inflamma ...

infections. It represents the presence of anterior stromal infiltrates. Unilateral or bilateral subepithelial lesions of the

cornea The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical power ...

may be present. Slit lamp examination reveals multiple tiny granular deposits surrounded by a halo of stromal haze. After healing, residual 'nummular scars' often remain. Disciform keratitis occurs in 50% of individuals with Nummular keratitis, but Nummular keratitis always precedes Disciform keratitis.

Treatment

* Topical NSAIDS * Lubricating eye drops * Topical dilute steroid drops in tapering doses (debatable, see: Adenoviral keratoconjunctivitis)

References

{{Reflist Ophthalmology Ophthalmology task force articles