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Case Reports
. 2008 Sep;2(3):649-55.
doi: 10.2147/opth.s2430.

Conjunctival-corneal melt in association with carotid artery stenosis

Rosalind M K Stewart  1 , Say Aun Quah, Dan Q Nguyen, Stephen B Kaye
Affiliations
Free PMC article
Case Reports

Conjunctival-corneal melt in association with carotid artery stenosis

Rosalind M K Stewart et al. Clin Ophthalmol. 2008 Sep.
Free PMC article

Abstract

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: carotid artery stenosis; conjunctival melt; corneal melt; ocular ischemia.

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Figures

Figure 1
Figure 1
Spontaneous nonhealing conjunctival defect.
Figure 2
Figure 2
Large persistent conjunctival defect post corneal gluing.
See this image and copyright information in PMC

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