Clofazimine-induced crystalline keratopathy in a leprosy patient

A young male in his late 20s presented with brownish discolouration of the conjunctiva and periocular area of both eyes. He was diagnosed as a case of lepromatous leprosy with recurrent type II lepra reaction 4 years ago and was started on multidrug therapy-multi bacillary, which included clofazimine. The best-corrected visual acuity was 20/20 in both eyes. Examination revealed reddish-brown discolouration of the facial skin including the periorbital area and the eyelids, brownish discolouration of the conjunctiva with shiny sub-conjunctival deposits and multiple polychromatic refractile crystalline corneal deposits. Both eyes had clear lenses with normal fundus. On follow-up after 4 months of discontinuing clofazimine and again after 1 year, the deposits had decreased than previous visits, but they had not totally disappeared. Few studies documented similar ocular side effects of this drug. When diagnosing crystalline deposits in the cornea and conjunctiva, one should rule out clofazimine-induced crystalline keratopathy especially in a leprosy patient.