Lichen Planus in Ocular Surface: Major Presentations and Treatments

Area of Science:

• Ophthalmology
• Dermatology
• Immunology

Background:

• Ocular lichen planus (LP) is a rare inflammatory condition increasingly reported in recent literature.
• It primarily affects the conjunctiva, cornea, and lacrimal drainage system, often presenting as cicatricial conjunctivitis.

Purpose of the Study:

• To review the clinical presentation, treatment strategies, and outcomes for ocular lichen planus.
• To highlight the involvement of the ocular surface and lacrimal drainage system in LP.

Main Methods:

• Literature review of reported cases of ocular lichen planus.
• Analysis of clinical findings, treatment modalities, and surgical outcomes.

Main Results:

• Ocular LP commonly causes cicatricial conjunctivitis with subepithelial fibrosis, fornix shortening, and symblepharon.
• Topical corticosteroids and cyclosporine are first-line treatments for ocular surface involvement.
• Systemic immunosuppressives are indicated for severe cases, with long-term maintenance therapy essential.
• Lacrimal drainage system involvement, often bilateral, presents with stenosis requiring advanced surgical interventions with variable outcomes.

Conclusions:

• Ocular lichen planus requires a multi-faceted treatment approach, combining topical and systemic therapies.
• Management focuses on controlling inflammation, preventing progression, and addressing complications like lacrimal duct obstruction.
• Long-term monitoring and maintenance therapy are critical for managing this chronic condition.