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Conjunctival Inclusion Cysts in Long-standing Chronic Vernal Keratoconjunctivitis.

Lee SW, Lee SC, Jin KH - Korean J Ophthalmol (2007)

Bottom Line: For relief of foreign body sensation, excision of the conjunctival cysts and giant papillae of the left eye and histopathologic examination of the specimen was performed.On histopathological examination, the conjunctival cysts consisted of nonkeratinizing stratified epithelial cells filled with PAS-positive mucous substance.Inflammatory cells were not found in the vicinity.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Kyung Hee University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To report a case of conjunctival inclusion cysts on the corneal limbus of a patient with chronic vernal keratoconjunctivitis during 16 months' follow up.

Methods: The patient was a 26 year old male without any specific history of surgery or trauma. Giant papillae, shield ulcers, and Horner-Trantas dots were detected. During the 16 month follow-up, Sodium cromoglycate eye drops and Prednisolone acetate 1% eye drops were given 3 times a day. During this period, conjunctival cysts were detected on the corneal limbus in both eyes. In spite of improvement of the corneal and conjunctival conditions, the conjunctival cysts did not seem to show any specific changes. For relief of foreign body sensation, excision of the conjunctival cysts and giant papillae of the left eye and histopathologic examination of the specimen was performed.

Results: On histopathological examination, the conjunctival cysts consisted of nonkeratinizing stratified epithelial cells filled with PAS-positive mucous substance. Inflammatory cells were not found in the vicinity.

Conclusions: Conjunctival inclusion cysts can be seen as an atypical finding of long-standing vernal keratoconjunctivitis. Mechanical friction between the giant papillae and conjunctiva may be a factor in inducing the formation of the conjunctival cysts.

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Related in: MedlinePlus

Giant papillae with flat tops on the upper tarsal conjunctiva (dot-arrow), typically described as a 'cobblestone' appearance were the hallmark of vernal keratoconjunctivitis and were different in shape compared with hypertrophic conjunctival cicatrization (lined-arrow). The size of the giant papillae in the left eye was larger than that of the right eye (A: Right eye, B: Left eye).
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Figure 1: Giant papillae with flat tops on the upper tarsal conjunctiva (dot-arrow), typically described as a 'cobblestone' appearance were the hallmark of vernal keratoconjunctivitis and were different in shape compared with hypertrophic conjunctival cicatrization (lined-arrow). The size of the giant papillae in the left eye was larger than that of the right eye (A: Right eye, B: Left eye).

Mentions: In January of 2003, a healthy 26 year old male without any history of surgery or trauma visited our hospital for deterioration of vision and persisting pain in both eyes, which started one week before the visit. The corrected vision of both eyes at the time of visit was 20/40 in each eye. The patient did not have any prior allergic symptoms prior to this visit to the ophthalmologic clinic. On slit lamp examination, giant papillae in the upper tarsal conjunctiva (Fig. 1), persistent epithelial defects and shield ulcers, Horner-Trantas dots and neovascularization in the corneal limbus were detected in both eyes. A diagnosis of vernal keratoconjunctivitis was made, and the corneal shield ulcer was treated with Sodium cromoglycate eye drops (Opticrom®, Sanofi-aventis, France) and Prednisolone acetate 1% eye drops (Pred forte®, Allergan, USA) 3 times a day. Even though there was improvement of the overall conditions of the cornea and conjunctiva and improvement of corrected vision to 20/25 in the right eye and 20/30 in the left eye, the giant papillae did not show any specific changes. In May 2004, at the 16 month period of follow up, conjunctival cysts that had not been detected previously were observed in the corneal limbus of both eyes (Fig. 2). Even with Sodium cromoglycate eye drops and Prednisolone acetate 1% eye drops 3 times a day, conjunctival cysts did not disappear. The size of the cysts was larger in the left eye compared with the right, corresponding with the size of giant papillae, which was also larger in the left eye.


Conjunctival Inclusion Cysts in Long-standing Chronic Vernal Keratoconjunctivitis.

Lee SW, Lee SC, Jin KH - Korean J Ophthalmol (2007)

Giant papillae with flat tops on the upper tarsal conjunctiva (dot-arrow), typically described as a 'cobblestone' appearance were the hallmark of vernal keratoconjunctivitis and were different in shape compared with hypertrophic conjunctival cicatrization (lined-arrow). The size of the giant papillae in the left eye was larger than that of the right eye (A: Right eye, B: Left eye).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2629892&req=5

Figure 1: Giant papillae with flat tops on the upper tarsal conjunctiva (dot-arrow), typically described as a 'cobblestone' appearance were the hallmark of vernal keratoconjunctivitis and were different in shape compared with hypertrophic conjunctival cicatrization (lined-arrow). The size of the giant papillae in the left eye was larger than that of the right eye (A: Right eye, B: Left eye).
Mentions: In January of 2003, a healthy 26 year old male without any history of surgery or trauma visited our hospital for deterioration of vision and persisting pain in both eyes, which started one week before the visit. The corrected vision of both eyes at the time of visit was 20/40 in each eye. The patient did not have any prior allergic symptoms prior to this visit to the ophthalmologic clinic. On slit lamp examination, giant papillae in the upper tarsal conjunctiva (Fig. 1), persistent epithelial defects and shield ulcers, Horner-Trantas dots and neovascularization in the corneal limbus were detected in both eyes. A diagnosis of vernal keratoconjunctivitis was made, and the corneal shield ulcer was treated with Sodium cromoglycate eye drops (Opticrom®, Sanofi-aventis, France) and Prednisolone acetate 1% eye drops (Pred forte®, Allergan, USA) 3 times a day. Even though there was improvement of the overall conditions of the cornea and conjunctiva and improvement of corrected vision to 20/25 in the right eye and 20/30 in the left eye, the giant papillae did not show any specific changes. In May 2004, at the 16 month period of follow up, conjunctival cysts that had not been detected previously were observed in the corneal limbus of both eyes (Fig. 2). Even with Sodium cromoglycate eye drops and Prednisolone acetate 1% eye drops 3 times a day, conjunctival cysts did not disappear. The size of the cysts was larger in the left eye compared with the right, corresponding with the size of giant papillae, which was also larger in the left eye.

Bottom Line: For relief of foreign body sensation, excision of the conjunctival cysts and giant papillae of the left eye and histopathologic examination of the specimen was performed.On histopathological examination, the conjunctival cysts consisted of nonkeratinizing stratified epithelial cells filled with PAS-positive mucous substance.Inflammatory cells were not found in the vicinity.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Kyung Hee University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To report a case of conjunctival inclusion cysts on the corneal limbus of a patient with chronic vernal keratoconjunctivitis during 16 months' follow up.

Methods: The patient was a 26 year old male without any specific history of surgery or trauma. Giant papillae, shield ulcers, and Horner-Trantas dots were detected. During the 16 month follow-up, Sodium cromoglycate eye drops and Prednisolone acetate 1% eye drops were given 3 times a day. During this period, conjunctival cysts were detected on the corneal limbus in both eyes. In spite of improvement of the corneal and conjunctival conditions, the conjunctival cysts did not seem to show any specific changes. For relief of foreign body sensation, excision of the conjunctival cysts and giant papillae of the left eye and histopathologic examination of the specimen was performed.

Results: On histopathological examination, the conjunctival cysts consisted of nonkeratinizing stratified epithelial cells filled with PAS-positive mucous substance. Inflammatory cells were not found in the vicinity.

Conclusions: Conjunctival inclusion cysts can be seen as an atypical finding of long-standing vernal keratoconjunctivitis. Mechanical friction between the giant papillae and conjunctiva may be a factor in inducing the formation of the conjunctival cysts.

Show MeSH
Related in: MedlinePlus