Objectives. Report of a clinical case reuniting the dry eye syndrome in a severe form, the Mooren's ulcer and necrotizing anterior scleritis with inflammation, with bilateral affectation in the context of chronic infection with the hepatitis C virus. Methods. A female patient aged 66 diagnosed with chronic hepatitis with HCV, with ophthalmological antecedents of Mooren's ulcer and severe form of dry eye syndrome in both eyes, comes to the emergency unit with hypopyon corneal ulcer in the right eye, shortly afterwards developing necrotizing anterior scleritis with inflammation. The patient is administered treatment for chronic hepatitis C, following which the ARN-HCV viremia decreases without ocular exacerbations. When the viremia level increases again, two lesions indicating necrotizing anterior scleritis are observed in the left eye. The evolution is favourable with topical and systemic treatment with corticosteroids. Complicated cataract is surgically treated in the right eye and vitreous humour is collected during surgery. Results. Visual acuity increases in the right eye after the surgery, while antibodies-HCV are identified in the vitreous humour. Conclusions. Chronic infection with hepatitis C virus displays multiple extra-hepatic manifestations and the ophthalmological ones require a multidisciplinary approach from both the chronic diseases practitioner and the ophthalmologist.
Keywords: Mooren’s ulcer; dry eye syndrome; hepatitis C virus; necrotizing anterior scleritis.