Conjunctival-corneal melt in association with carotid artery stenosis.
OBJECTIVE
To report a case of severe conjunctival-corneal melt in association with carotid artery stenosis.


METHODS
Observational case report.


RESULTS
A 76-year-old man with a history of bilateral severe carotid artery occlusion and nonarteritic ischemic optic neuropathy developed a spontaneous bulbar conjunctival defect. Despite intensive lubrication, and attempts at surgical closure including an amniotic membrane patch graft, it progressed with subsequent adjacent corneal perforation. Thorough investigations revealed no underlying disease, except markedly delayed episcleral vessel filling on anterior segment fluorescein angiography.


CONCLUSIONS
Neovascularisation is a known factor in the inhibition of ulceration. In light of the findings in this report, ocular ischemia should be considered as a cause or contributing factor in the differential diagnosis of conjunctival-corneal melt.
Stewart
Rosalind M K
RM
St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK. rosalindstewart@doctors.org.uk
Quah
Say Aun
SA
Nguyen
Dan Q
DQ
Kaye
Stephen B
SB