Sterile Corneal Melt Following Intravesical Bacillus Calmette–Guerin Therapy for Bladder Carcinoma: A Case Report

Intravesical Bacillus Calmette–Guérin (BCG) therapy is a widely utilized treatment for urinary bladder carcinoma. However, it has been associated with various ocular and systemic complications. We, here, report a case of a 63-year-old male who presented to our outpatient department after a significant drop in vision to 1/60 after a course of pain, congestion, and discharge. The patient was being treated with broad-spectrum antibiotics and topical steroids. At presentation, slit-lamp examination revealed a sterile corneal perforation. A prompt surgical intervention with tissue adhesive application was performed. Culture from conjunctival swab revealed no growth. The patient was treated with topical steroids and lubricant and responded well with recorded best corrected visual acuity of 6/12. This case represents an untoward incident due to immune-mediated response to intravesical BCG therapy. This case highlights the importance of meticulous systemic history and a higher degree of suspicion while examining the patients with preexisting systemic conditions.