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Marginal Keratitis After Intravitreal Injection of Ranibizumab

Purpose: To report a case of marginal keratitis that developed after intravitreal ranibizumab injection. Methods: A 56-year-old man with diffuse diabetic macular edema received intravitreal injection of ranibizumab into his right eye. Results: One day after injection, the patient presented with pain, redness, tearing, and discomfort in his right eye. Anterior segment examination of the right eye revealed subconjunctival hemorrhage, 3 corneal subepithelial peripheral infiltrates separated from the limbus by a clear zone, and mild anterior chamber reaction. Examination of the eyelids was remarkable for mild blepharitis. Fungal and bacterial cultures were negative. The condition resolved with topical corticosteroids and antibiotics. Conclusions: Intravitreal ranibizumab injection may trigger hypersensitivity reaction in the form of marginal keratitis in patients with mild blepharitis.