A 25-year-old man with a history of rheumatoid arthritis currently taking oral methotrexate, 25 mg per week, presented with a lesion of the left bulbar conjunctiva of about 1 month’s duration. He had no other symptoms other than occasionally noticing a sensation of a foreign body in that eye and denied any changes in his vision. He had no history of contact lens use, ocular trauma, or ocular surgery. His only other medications were oral vitamin D and folic acid. He was initially treated with topical antibiotics followed by a course of oral sulindac, 200 mg twice daily, without any improvement.
Starr MR, Louwagie CR, Salomao DR. Bulbar Conjunctival Nodule in a Patient With Rheumatoid Arthritis. JAMA Ophthalmol. 2018;136(4):438–439. doi:10.1001/jamaophthalmol.2017.4271
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