Immuno‐Suppressive Drug Treatment of Keratitis Sicca, including an Example of Lichen Planus of the Conjunctiva

Abstract

Progressive keratitis sicca is described in two patients, one of whom lost on eye. The other patient became blind as a result of lichen planus of the conjunctiva. Autoimmunity is briefty discussed and the apparent therapeutic effect of asathioprine in these patients is described.

Immunopathology and histopathology of conjunctival biopsies in patients with presumed idiopathic punctal stenosis

“…Conjunctival involvement with LP is a relatively rare feature of the disease, with 64 cases described in the literature and the vast majority of patients presenting with cicatricial changes. 5,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24 Even more uncommonly reported is LP with lacrimal drainage system involvement. Only 11 such patients have been described in various case reports and series 9,10 before Durrani et al (2008) performed a retrospective review of 184 patients with canalicular obstruction.…”

“…These cases seem to be examples of LP isolated to the conjunctiva and lacrimal drainage system leading to punctal stenosis without other systemic systemic or clinical conjunctival findings. While there are three published reports describing six patients with isolated LP leading to cicatricial conjunctivitis 14,15,25 , these cases centered on the conjunctival findings without description of the examination of the lacrimal system.…”

Lichen planus and cicatricial conjunctivitis: disease course and response to therapy of 11 patients

“…Ocular LP first was reported by Gaucher and Druelle 10 in 1904 described as white streaks on the palpebral conjunctiva. To our knowledge, only 18 cases of ocular LP involving the conjunctiva have been reported in the English‐language medical literature since 1950 6–8,11–17 …”

“…To our knowledge, only 18 cases of ocular LP involving the conjunctiva have been reported in the English-language medical literature since 1950. [6][7][8][11][12][13][14][15][16][17] Because the clinical presentation of ocular LP may be indistinguishable from other forms of cicatricial conjunctivitis, histopathologic analysis of tissue samples and a thorough clinical examination may help distinguish this entity from other disease processes such as mucous membrane pemphigoid. Other, rarer causes of cicatricial disease include Stevens-Johnson syndrome and atopic keratoconjunctivitis.…”

Superficial Keratitis

“…Crompton (1968) reported the improvement of Schirmer test values after azathioprine (Immurane®) therapy in a case of lichen planus and another with keratoconjunctivitis sicca who had thyroglobulin antibodies and antibody to gastric parietal cells. Crompton (1968) reported the improvement of Schirmer test values after azathioprine (Immurane®) therapy in a case of lichen planus and another with keratoconjunctivitis sicca who had thyroglobulin antibodies and antibody to gastric parietal cells.…”