Ligneous Conjunctivitis: Causes, Symptoms, and Treatment

Ligneous conjunctivitis is a rare and chronic eye disease that affects the conjunctiva, a thin and transparent membrane that covers the white of the eye and the inner surface of the eyelid. The disease is characterized by the formation of thick, woody, and yellowish-white pseudomembranes that adhere to the conjunctiva, causing inflammation, scarring, and vision loss. Here is what you need to know about the causes, symptoms, and treatment of ligneous conjunctivitis.

1. Causes: Ligneous conjunctivitis is caused by a genetic deficiency of plasminogen, a protein that dissolves blood clots and prevents the formation of fibrin, a fibrous protein that is the main component of pseudomembranes. Without plasminogen, fibrin accumulates and forms pseudomembranes that adhere to the conjunctiva. The deficiency can be inherited or acquired, and it affects both genders equally.
2. Symptoms: The symptoms of ligneous conjunctivitis include redness, swelling, itching, tearing, discharge, photophobia, and vision loss. The pseudomembranes can grow rapidly and cover the cornea, the clear dome-shaped surface that covers the iris and the pupil, leading to astigmatism, irregular astigmatism, and corneal ulceration. The disease can also affect other mucous membranes, such as the nose, the mouth, the tracheobronchial tree, and the genital tract.
3. Treatment: The treatment of ligneous conjunctivitis aims to remove the pseudomembranes, prevent their recurrence, and preserve the vision. The first line of treatment is the administration of systemic and topical plasminogen, which can dissolve the pseudomembranes and prevent their formation. The plasminogen can be obtained from human plasma, or produced by recombinant DNA technology. The second line of treatment is the surgical removal of the pseudomembranes, which can be performed with a scalpel, a laser, or a cryoprobe. The third line of treatment is the use of immunosuppressive drugs, such as corticosteroids, cyclosporine, or tacrolimus, which can reduce the inflammation and scarring. The treatment should be individualized according to the severity and location of the disease, and monitored regularly with ophthalmic examinations.

In conclusion, ligneous conjunctivitis is a rare and challenging eye disease that requires a multidisciplinary approach. The genetic deficiency of plasminogen is the main cause of the disease, and the pseudomembranes are the main symptom. The treatment should aim to remove the pseudomembranes, prevent