Penicillamine, sold under the brand name of Cuprimine among others, is a medication primarily used for the treatment of Wilsons disease. It is also used for people with kidney stones who have high urine cystine levels, rheumatoid arthritis, and various heavy metal poisonings. It is taken by mouth. Medical uses
Penicillamine was approved for medical use in the United States in 1970. It is on the World Health Organizations List of Essential Medicines.It is used as a chelating agent:

In Wilsons disease, a rare genetic disorder of copper metabolism, penicillamine treatment relies on its binding to accumulated copper and elimination through urine. Penicillamine was the second line treatment for arsenic poisoning, after dimercaprol (BAL). It is no longer recommended.In cystinuria, a hereditary disorder in which high urine cystine levels lead to the formation of cystine stones, penicillamine binds with cysteine to yield a mixed disulfide which is more soluble than cystine.Penicillamine has been used to treat scleroderma.Penicillamine can be used as a disease-modifying antirheumatic drug (DMARD) to treat severe active rheumatoid arthritis in patients who have failed to respond to an adequate trial of conventional therapy, although it is rarely used today due to availability of TNF inhibitors and other agents, such as tocilizumab and tofacitinib. Penicillamine works by reducing numbers of T-lymphocytes, inhibiting macrophage function, decreasing IL-1, decreasing rheumatoid factor, and preventing collagen from cross-linking. Adverse effects
Common side effects include rash, loss of appetite, nausea, diarrhea, and low blood white blood cell levels. Other serious side effects include liver problems, obliterative bronchiolitis, and myasthenia gravis.
Since normal corneal tissue should be avascular (no blood vessel) and therefore clear to allow light to pass, the presence of blood vessel and the infiltration of cells as part of the inflammatory process results in scarring or hazing of the cornea. Diagnosis
A positive VDRL of Treponema pallidum immobilization test confirms diagnosis of luetic(syphilitic) interstitial keratitis

Treatment
The underlying cause must be treated as soon as possible to stop the disease process. Corticosteroid drop can be used to minimize the scarring on the cornea along with antibiotic cover. However, residual scarring cannot be avoided which can result in long term visual impairment and corneal transplantation is not suitable due to high rejection rate from the corneal vascularization. History
Previous long-standing eye infection which possibly during childhood time recalled as being treated with antibiotic and/or hospitalized over long period of time. == References ==