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BMJ Case Reports 2017; doi:10.1136/bcr-2017-220973
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Customised crescentic corneal transplant with conjunctival resection in an atypical case of malignant Mooren’s ulcer

  1. Amar Pujari
  1. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
  1. Correspondence to Dr Jayanand Urkude, drjay2910{at}gmail.com
  • Accepted 25 June 2017
  • Published 17 July 2017

Description

Mooren’s ulcer is a painful peripheral ulcerative keratitis of unknown aetiology. It is rapidly progressive inflammatory destruction of the juxtalimbal corneal stroma with no associated scleritis. Mooren’s ulcer is a diagnosis of exclusion, after ruling out all the relevant systemic and local causes that lead to peripheral ulcerative keratitis. It usually present as bilateral disease with male to female distribution of 1:0.74 being more common in older age group.1 Mooren’s ulcer has been seen to be associated with human leucocyte antigen (HLA)-DR17(3) and DQ2.2

A 20-year-old male patient presented with complaints of sudden onset pain, redness and watering in the left eye. History revealed recurrent episodes of similar complaints for the last 2 years. On examination, the visual acuity in the left eye was counting finger at 2 m and 20/20 in the right eye. The slit-lamp biomicroscopic examination showed juxtalimbal severe congestion associated with 2×2 mm of perforation between 8 and 9 clock hours with uveal tissue …

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