Spontaneous Healing in Nomas of the Eyelid

A noma is an acute, necrotizing ulcerative mucositis, also known as cancrum oris, which occurs commonly in children, 2–5 years of age, having a debilitating illness or severe malnourishment. This gangrene lives up to the meaning of its Greek name, by rapidly devouring all adjacent soft tissues, and in some cases even bone. It generally affects the mouth and genitalia and infrequently involves the lid and other extraocular tissues1–3. A noma spreads painlessly and has been reported to leave extensive and complex facial defects2,4,5. Surprisingly, the nomas seen at the Lady Hardinge Medical College and Smt. Kalawati Saran Children's Hospital have been noted to heal without any disfiguring defects when maintained on supportive nutritional therapy and antibiotics without any surgical manipulation during the active or healing phases of the disease. We detail the history and findings in one such case to emphasize the excellent cosmetic and functional results obtained by this purely conservative management.