Ring keratopathy in a patient with psoriatic arthritis and ulcerative rectocolitis

Purpose: To describe a bilateral ring-shaped corneal opacity associated to immunological bowel and skin diseases.Methods: Ophthalmic examination, tear film evaluation, ultrasound biomicroscopy (UBM), rheumatologic examination, and haematological screening. Results: A 30-year-old man with psoriatic arthritis and ulcerative rectocolitis showed an unusual bilateral ring keratopathy not responding to topical and oral anti-inflammatory treatment. UBM examination revealed the high reflectivity of lesions distributed in the anterior stroma. Conclusion: Although association with systemic autoimmune diseases together with the ring aspect could suggest the immunological origin of corneal lesions, degenerative keratopathy cannot be excluded because the poor response to therapy alongside the UBMfindings.