Conjunctival-corneal melt in association with carotid artery stenosis

Case report

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Authors: Rosalind MK Stewart, Say Aun Quah, Dan Q Nguyen, Stephen B Kaye

Published Date October 2008 Volume 2008:2(3) Pages 649 - 652

DOI: http://dx.doi.org/10.2147/OPTH.S2430

Rosalind MK Stewart¹, Say Aun Quah¹, Dan Q Nguyen², Stephen B Kaye¹

¹Royal Liverpool University Hospital, Liverpool, UK; ²Bristol Eye Hospital, Bristol, UK

Purpose: To report a case of severe conjunctival-corneal melt in association with carotid artery stenosis.

Methods: Observational case report.

Results: A 76-year-old man with a history of bilateral severe carotid artery occlusion and nonarteritic ischemic optic neuropathy developed a spontaneous bulbar conjunctival defect. Despite intensive lubrication, and attempts at surgical closure including an amniotic membrane patch graft, it progressed with subsequent adjacent corneal perforation. Thorough investigations revealed no underlying disease, except markedly delayed episcleral vessel filling on anterior segment fluorescein angiography.

Conclusions: Neovascularisation is a known factor in the inhibition of ulceration. In light of the findings in this report, ocular ischemia should be considered as a cause or contributing factor in the differential diagnosis of conjunctival-corneal melt.

Keywords: conjunctival melt, corneal melt, ocular ischemia, carotid artery stenosis