Peripheral ulcerative keratitis (PUK) is a unilateral crescent-shaped stromal inflammation that has long been associated with collagen vascular disease such as rheumatoid arthritis (RA)1. PUK in RA generally appears late in the disease course, and usually signals worsening of the systemic disease2,3. Tumor necrosis factor-α inhibitor (TNFi) has been reported to be effective in RA-associated PUK cases refractory to …