Sterile corneal perforations in a case of severe dry eyes

Sterile corneal ulcers and perforations can occur as a result of eye injury, Mooren's ulcer etc as an isolated ocular problem or they may be associated with various collagen vascular or other autoimmune diseases. Recurrent corneal erosions, exposure keratitis, neurotrophic keratitis, keratomalacia that affect the integrity of the ocular surface epithelium may also sometimes result in the development of sterile corneal ulcers.1Sterile corneal ulceration is a serious complication in patients with keratoconjunctivitis sicca.1–4 The common etiologies of dry eyes leading to corneal perforation include Sjogren's syndrome, rheumatoid arthritis, ocular pemphigoid, atopy and local irradiation.2–4 We report an uncommon case of sterile corneal perforation in severe dry eye without any underlying systemic cause.