Handling punctate keratitis resulting from systemic cytarabine.

A young patient with acute myelogenous leukemia was treated with high-dose cytarabine (3.0 g/m2 every 12 hours). After five days of treatment, he developed severe photophobia and decreased visual acuity. On examination, progressive punctate keratitis was found. We discuss the mechanism of the cytarabine-induced corneal toxicity and the prophylactic use of topical corticosteroids.