Conjunctivitis ligneous

Conjunctivitis Ligneous is a rare form of conjunctivitis characterized by the development of firm, woody-like pseudomembranes on the conjunctiva, the mucous membrane that covers the white part of the eye and the inner surface of the eyelids. This condition is chronic and can lead to severe visual impairment or blindness if not properly managed. It is also known as ligneous conjunctivitis.

Causes

Conjunctivitis Ligneous is primarily caused by a deficiency in the blood coagulation factor, plasminogen. This deficiency leads to the accumulation of fibrin on the conjunctival surfaces, resulting in the formation of the characteristic ligneous pseudomembranes. The condition can be congenital, due to a genetic mutation in the PLG gene, which is responsible for the production of plasminogen, or acquired, though the acquired form is extremely rare.

Symptoms

The main symptom of Conjunctivitis Ligneous is the presence of thick, wood-like membranes on the conjunctiva. These membranes are usually red or pink and can cause severe discomfort. Other symptoms may include:

• Eye redness
• Eye pain
• Swelling of the eyelids
• Blurred vision
• Sensitivity to light (photophobia)

Diagnosis

Diagnosis of Conjunctivitis Ligneous involves a comprehensive eye examination. A healthcare provider may also perform a biopsy of the conjunctival membranes to confirm the presence of fibrin. Genetic testing for mutations in the PLG gene can confirm a diagnosis of congenital plasminogen deficiency.

Treatment

Treatment of Conjunctivitis Ligneous focuses on managing symptoms and preventing the progression of the disease. Options may include:

• Topical eye drops containing corticosteroids to reduce inflammation
• Topical plasminogen or lysine analogs to help dissolve the pseudomembranes
• Surgical removal of the membranes in severe cases

In cases of congenital plasminogen deficiency, systemic plasminogen replacement therapy may be considered to address the underlying cause.

Prognosis

The prognosis for individuals with Conjunctivitis Ligneous varies. With appropriate treatment, symptoms can be managed, and the progression of the disease can be halted. However, without treatment, the condition can lead to significant visual impairment or blindness.

Epidemiology

Conjunctivitis Ligneous is extremely rare, with only a few hundred cases reported in the medical literature. It can affect individuals of any age but is most commonly diagnosed in childhood.

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