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Phlyctenular Keratoconjunctivitis

(Phlyctenular Conjunctivitis; Phlyctenulosis)

By Melvin I. Roat, MD, FACS, Clinical Associate Professor of Ophthalmology; Cornea Service, Sidney Kimmel Medical College at Thomas Jefferson University; Wills Eye Hospital

Phlyctenular keratoconjunctivitis is an eye disorder that involves an immune reaction of the cornea (the clear layer in front of the iris and pupil) and conjunctiva (the membrane that lines the eyelids and covers the white of the eye) to bacteria.

Locating the Cornea

Phlyctenular keratoconjunctivitis is not an infection. It is an immune reaction to bacteria that are on or around the eyes. Some of the bacteria that trigger this disorder are staphylococci, tuberculosis, and Chlamydia. This disorder is more common among children. Many people also have inflammation, redness, or swelling at the edges of the eyelids (blepharitis).


Small, yellow-gray, raised bumps (called phlyctenules) appear at the limbus (the area where the conjunctiva attaches to the cornea), on the cornea, or on the conjunctiva. The bumps last for several days to 2 weeks. On the conjunctiva, these bumps become open sores (ulcers) but heal without a scar. When the cornea is affected, severe tearing, photophobia (pain when light is shined into the eye), blurred vision, aching, and a feeling like a foreign object is in the eye (foreign body sensation) may be noticeable.

People who have frequent recurrences may develop cloudy corneas, and tiny blood vessels may grow across their corneas. Their vision may become impaired.


  • A doctor's evaluation of the eyes

The diagnosis of phlyctenular keratoconjunctivitis is based on the typical appearance of the eyes.

Doctors may test some people for tuberculosis.


  • Corticosteroid/antibiotic eye drops

  • For seborrheic blepharitis, eyelid scrubs

People who do not have tuberculosis are given eye drops that contain a combination of corticosteroids and antibiotics.

People who have blepharitis caused by the skin condition seborrheic dermatitis (seborrheic blepharitis) can gently scrub the edges of the eyelids to help prevent the disorder from coming back (see Treatment of Blepharitis).

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