title: Ligneous conjunctivitis: a clinicopathologic study of 3 cases.
abstract: The clinical, histopathologic features, and treatment outcomes in 3 patients with ligneous conjunctivitis are described. Bilateral, idiopathic membranes occurred in the palpebral conjunctiva in 2 patients. In 1 patient, unilateral conjunctival changes occurred in the bulbar conjunctiva, at the site of pterygium excision. Treatment included topical hyaluronidase, chymotrypsin, heparin, and cyclosporine and surgical excision with limited or no success. In one patient, conjunctival autografting from the normal fellow eye resulted in pseudomembrane formation at the donor site in the previously unaffected eye. Histopathological evaluation of excised membranes revealed the presence of amorphous eosinophilic hyaline material and chronic inflammatory cells. Immunohistochemical study revealed a predominance of T-lymphocytes. This case series confirms the recalcitrant clinical course of ligneous conjunctivitis. Conventional treatment modalities described in literature were not useful in the management of this condition. Surgical manipulation of the unaffected fellow eye in patients with unilateral disease can result in pathologic conjunctival changes, and is best avoided.
authors.affiliation: Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India. MDSAAA35giasmd01.vsnl.net.in.
authors.forename: S K
authors.initials: SK
authors.lastname: Rao
authors.forename: J
authors.initials: J
authors.lastname: Biswas
authors.forename: R
authors.initials: R
authors.lastname: Rajagopal
authors.forename: G
authors.initials: G
authors.lastname: Sitalakshmi
authors.forename: P
authors.initials: P
authors.lastname: Padmanabhan
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D002908:Chronic Disease; D002918:Chymotrypsin / Q000008:administration & dosage / Q000627:therapeutic use; D003228:Conjunctiva / Q000473:pathology*; D003231:Conjunctivitis / Q000473:pathology / Q000628:therapy; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D012008:Recurrence
chemical_list: D000925:Anticoagulants; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine; D006493:Heparin; D006821:Hyaluronoglucosaminidase; D002918:Chymotrypsin