Cornea

Peripheral Ulcerative Keratitis

Also known as: PUK, peripheral ulcerative keratitis, peripheral corneal melt, corneal melt vasculitis, limbal ulceration, rheumatoid corneal melt, wegener keratitis, peripheral corneal thinning

Overview

A sight-threatening, limbus-adjacent corneal ulceration caused by immune-mediated mechanisms rather than infection. Characterised by crescent-shaped peripheral corneal thinning and ulceration, often with an overhanging edge. Strongly associated with systemic vasculitis, particularly rheumatoid arthritis, GPA (Wegener's granulomatosis), and polyarteritis nodosa. The discovery of PUK should prompt urgent systemic investigation — associated systemic vasculitis carries significant mortality if untreated.

What OptoGuide™ covers for peripheral ulcerative keratitis

  • Recognition patterns — symptoms, signs, and differentiators
  • Don't-miss risks and escalation triggers
  • Management tiers with linked Australian therapeutics
  • Referral urgency, specialty, and letter drafting

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