Bilateral peripheral ulcerative keratitis in a child with juvenile idiopathic arthritis.

Peripheral ulcerative keratitis (PUK) is characterized by epithelial destructive lesions in the perilimbal cornea causing corneal thinning. It is an inflammatory condition commonly associated with systemic autoimmune disorders and mainly found in middle-aged females. It is a sight threatening entity with potential for severe visual impairment or loss of eye. Recognition of ocular manifestations of PUK is essential especially in the younger age group, as it is difficult to diagnose in a child. We present a unique case of a 13-year-old girl with bilateral PUK and later diagnosed with juvenile idiopathic arthritis. She was started on methotrexate tablets to control the systemic disease and advised continuation of topical cyclosporine eye drops.