Corneal perforation associated with ocular rosacea and neurotrophic keratopathy

Rosacea is a dermatologic condition that affects the midfacial region. This chronic inflammatory disease can present with ocular manifestations distinguished by meibomian gland dysfunction, dry eye, and in severe cases, corneal ulceration and perforation. Neurotrophic keratopathy is an ocular condition with a reduced or absent corneal sensation associated with a corneal epitheliopathy. We present a 68-year-old man with both ocular rosacea and neurotrophic keratopathy who developed a corneal perforation. It was managed successfully with a tectonic keratoplasty in addition to topical steroids, lubrication, and oral tetracyclines. The perforation is explained by the superposition of both pathologies which lead to dry eye syndrome, along with chronic inflammation of the ocular surface. The effective follow-up and treatment of any epithelial defect in these patients is a major factor for corneal melting and perforation prevention