Nummular keratitis – A modern-day conundrum

Normal corneal structure and function is essential for excellent vision and comfort. Sometimes, however, the presence of fine granular opacities in the shape of a coin can cause extreme patient discomfort and vision loss, and this condition is termed nummular keratitis. This is not a new entity, although it has acquired greater significance in recent times. With the recent endemic presence of severe adenovirus keratoconjunctivitis, this is probably the most important cause of nummular keratitis today. This article attempts to answer these questions and provide a rationale for the clinical approach to the management of adenoviral keratoconjunctivitis.