Corneal plaques play role in nonhealing shield ulcers

Corneal plaques may precipitate on the denuded stromal beds of eyes with vernal keratoconjunctivitis, playing a pathogenic role in nonhealing shield ulcers, according to the authors of a small case series.

Abraham Solomon, MD, and colleagues described the cases of three children who presented with corneal plaques unresponsive to conservative systemic and topical medical treatment. Corneal plaques are a rare complication of vernal keratoconjunctivitis, the authors said.

The children were 4, 7.5 and 9 years old. The plaques were scraped under general anesthesia, and soft bandage contact lenses were placed.

The plaques were found to extend beyond the ulcer margins, the authors noted. Histopathology revealed granular, deeply eosinophilic, laminar material firmly attached to Bowman’s membrane in all cases. The material was confirmed by immunohistochemistry as eosinophil-derived major basic protein.

After removal of the plaques, complete epithelialization was evident within 1 to 4 weeks in all cases, the authors said.

The study is published in the August issue of Cornea.