Conjunctivitis

Conjunctivitis represents an inflammation of conjunctiva with cellular infiltration, exudation, and vascular dilation. According to the course of the disease, conjunctivitis can be acute, hyperacute, and chronic. Morphologically, conjunctivitis can appear with papillary reaction, follicular reaction, cicatrizing, granulomatous and membranous changes. This chapter discusses all types of conjunctivitis, their clinical signs and symptoms, and basic approaches of treatment. This chapter includes before and after treatment photos of atypical inferiorly localized shield ulcer, Tularemia-associated Parinaud oculoglandular syndrome, and Stevens-Johnson disease. Pictures are included In the ligneous conjunctivitis patient's case taken at diagnosis as well as 10 years later, demonstrating stable condition with appropriate treatment throughout the period.

Ligneous conjunctivitis associated with type I plasminogen deficiency: A rare case

Ligneous conjunctivitis is a rare form of chronic, recurrent conjunctivitis characterized by wood-like, fibrinous pseudomembranes, which may be associated with systemic disease manifestations. It has been associated with congenital plasminogen (PLG) deficiency that is inherited with an autosomal recessive pattern due to mutations in the PLG gene and a variety of other genes, leading to disturbed wound healing. In this case report, we present the clinical, laboratory, and histopathological findings of a 36-year-old female patient who presented at the ophthalmology department with complaints of redness, irritation for the previous few weeks, and appearance of membranous lesions mainly on the tarsal conjunctivae. During biomicroscopic examination we found thick, yellowish-white pseudomembranes, and conjunctival proliferation with ligneous induration on the conjunctiva, located on the upper eyelids. Histopathological evaluations showed up ligneous conjunctivitis and laboratory evaluation confirmed a severe plasminogen deficiency (PLG < 2%). The patient was treated with topical fresh frozen plasma (FFP), topical steroids, heparin eye drops, and artificial tear drops daily, without systemic therapy.

Fresh frozen plasma as a source of plasminogen for ligneous conjunctivitis: Case report and a review of the literature

Purpose: To describe management of a patient with ligneous conjunctivitis secondary to plasminogen deficiency and review the literature on treatment with plasminogen. Design: Interventional case report. Methods: A 6-year-old Caucasian girl developed ligneous conjunctivitis recalcitrant to debridement and treatment with topical cyclosporin A and steroids. The literature was reviewed regarding treatment of ligneous conjunctivitis with plasminogen. Results: The patient was treated with plasminogen containing drops derived from her father’s fresh frozen plasma. The ligneous conjunctivitis resolved, and the patient was managed on these drops for the following 8 years, initiating treatment for flares and tapering according to clinical response. Conclusions: Plasminogen drops concentrated from fresh frozen plasma are a safe and effective option for long-term treatment of ligneous conjunctivitis.