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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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Year : 2007  |  Volume : 14  |  Issue : 2  |  Page : 73-75

Bilateral pseudodendritic keratitis: A presentation of tyrosinemia type II

1 Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
2 Anterior Segment Division,King Saud University, Riyadh, Saudi Arabia
3 Anterior Segment Division, Ahoud Hospital, Madinah, Saudi Arabia

Correspondence Address:
Waleed A Al-Rashed
Anterior Segment Division, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

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A 9-month-old girl who presented with bilateral pseudodendritic keratitis was unresponsive to antiviral therapy. A diagnosis of tyrosinemia type II (Richner-Hanhart syndrome) was confirmed by high plasma tyrosine levels (2017 ΅mol/L). After the patient was placed on a low-protein diet that was supplemented with a tyrosine-restricted and phenylalanine-restricted formula (Mead-Johnson 3200 AB), the ocular symptoms and signs resolved. Tyrosinemia type II should be suspected in cases of resistant forms of bilateral dendritic keratitis. Timely initiation of dietary regimen will result in the rapid resolution of signs and symptoms, and prevent serious complications.

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