gms | German Medical Science

Ligneous conjunctivitis is a rare, chronic, recurrent pseudomembranous conjunctivitis forming nodular masses on the palpebral conjunctiva.

Case report with clinical and histopathological diagnostic findings.

A 31-year-old woman patient developed a therapy resistant, chronic conjunctivitis after intraocular surgery (secondary implantation of a posterior chamber lens). Large papillae with whitish deposits on the superior tarsal region were found. The tarsus was deformed by scaring lesions. Because of congenital cataract with secondary glaucoma, the patient was repeatedly operated on both eye. In November 2003, a surgical excision of the papillomatous deposits was performed with parallel cryotherapy of the tarsus. On histology, both granulation tissue with accompanying inflammatory infiltrate and necrotic areas and clotted fibrin deposits were found. The analysis of clotting parameter revealed a plasminogen deficiency of 17% compared to normal values. The conjunctivitis could be positively influenced by an after-treatment with a therapeutic contact lens and hyaluronic acid.

In chronic, therapy-resistant conjunctivitis with whitish, pseudomembranous, fibrin-rich deposits, especially after surgery, an early biopsy of the conjunctiva with histological examination is necessary. In suspect of conjunctivitis lignosa, the diagnosis can be confirmed by detection of a plasminogen type I deficiency.