Cogan (1) syndrome (nonsyphilitic interstitial keratitis)  262

General: Cause unknown; perhaps a generalized hypersensitivity reaction; most frequently affects young adults; unclear etiology; several studies suggest an autoimmunemediated process, possibly a vasculitis.

Ocular: Blepharospasm; lacrimation; congested conjunctival vessels; little or no reaction in anterior chamber but ciliary injection present; interstitial keratitis (unilateral or bilateral); granular-type infiltrates; patchy distribution in deeper stroma; later vascularization; conjunctivitis; corneal opacity; uveitis; nystagmus.

Clinical: Vestibuloauditory symptoms (similar to Ménière syndrome); nausea; vomiting; vertigo; tinnitus (abrupt onset); rapidly progressive deafness; loss of equilibration (see Ménière Syndrome); aortic insufficiency; sensorineural testing; lacunar infarcts.

Cheson BD, et al. Cogan's syndrome: a systemic vasculitis. Am J Med 1976; 70:549-555.

Cogan DG. Syndrome of non syphilitic interstitial keratitis and vestibuloauditory symptoms. Arch Ophthalmol 1945; 33:144.

Fraunfelder FT, Roy FH. Current Ocular Therapy, 5th ed. Philadelphia: WB Saunders, 2000.

Gilbert WS, Talbot FJ. Cogan's syndrome. Arch Ophthalmol 1969; 82:633.

Karni A, et al. Cogan's syndrome complicated by lacunar brain infarcts. J Neurol Neurosurg Psychiatry 1991; 54: 169-l71.

Oldenski R. Cogan syndrome: autoimmune-mediated audiovestibular symptoms and ocular inflammation. J Am Board Fam Pract 1993; 6:577-581.