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Corneal perforation associated with isolated ocular lichen planus: a case report
Daniela E Gomez-Elizondo1, Mariana Lopez-Martinez1, Raul Eduardo Ruiz-Lozano1
1Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico.
European Journal of Ophthalmology
|June 5, 2020
Summary
Ocular lichen planus, a rare condition, can cause corneal perforation, a severe complication previously unreported. Prompt diagnosis and treatment are vital for preventing vision loss in patients with severe dry eye.
Area of Science:
- Ophthalmology
- Dermatology
- Immunology
Background:
- Presents a rare case of unilateral corneal perforation attributed to isolated ocular lichen planus.
- Highlights the diagnostic challenge, as it mimics other cicatricial conjunctivitis forms.
Observation:
- A 64-year-old male with severe chronic dry eye disease experienced vision loss and corneal perforation.
- Clinical examination revealed subepithelial fibrosis and signs of severe dry eye; no other lesions were noted.
Findings:
- Excisional conjunctival biopsy with direct immunofluorescence confirmed fibrinogen deposit, indicative of ocular lichen planus.
- Treatment involved topical lubrication, corneal epithelial regenerators, topical tacrolimus, and systemic immunosuppression.
Implications:
- Corneal perforation is a novel, severe complication of ocular lichen planus.
- Emphasizes the necessity of thorough clinical assessment and histopathologic diagnosis for timely intervention and prevention of sight-threatening outcomes.
