Ligneous conjunctivitis: a case report.
BACKGROUND
Ligneous conjunctivitis is a rare condition characterized by chronic, recurrent conjunctivitis associated with pseudomembrane, and it may involve other mucous membranes in the mouth, nasopharynx, trachea, and vagina. We examined and treated a case of presumed ligneous conjunctivitis.


METHODS
The patient was a 10-year-old boy. His chief complaints were visual impairment, discomfort, and discharge, but no itching in his eyes. His upper eyelids appeared thick without swelling. He had a past history of surgery for lid entropion. His two siblings had similar follicular conjunctivitis.


METHODS
This case exhibited several characteristics of ligneous conjunctivitis, such as large follicles, recurrent pseudomembrane and normal level IgE in the serum. Indispensable characteristics of vernal keratoconjunctivitis, strong itching, and extensive papillary formation, were not found. In spite of the lack of woody hardness of the conjunctiva, other clinical findings led to the diagnosis of ligneous conjunctivitis. Definite histological diagnosis was not obtained, because of the lack of common histological characteristics among previously reported cases with ligneous conjunctivitis. The boy had developed corticosteroid glaucoma after instillation of dexamethasone 0.1% for 7 months at a previous time. We successfully treated this case with combined instillation of fluorometholon and cyclosporin after trabeculotomy.


CONCLUSIONS
Ligneous conjunctivitis must be considered as one type of differential diagnosis of vernal keratoconjunctivitis. Cyclosporin is an effective alternative for the treatment of ligneous conjunctivitis, especially in a case with a possible history of corticosteroid glaucoma.
Shimabukuro
M
M
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
Iwasaki
N
N
Nagae
Y
Y
Nakagawa
Y
Y
Ohtori
Y
Y
Inoue
Y
Y
Tano
Y
Y
D002648:Child; D003131:Combined Modality Therapy; D003231:Conjunctivitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016572:Cyclosporine / Q000627:therapeutic use; D004847:Epithelial Cells / Q000473:pathology; D005469:Fluorometholone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008566:Membranes / Q000473:pathology; D014130:Trabeculectomy
D016572:Cyclosporine; D005469:Fluorometholone