Conjunctival Ulcer in a Patient With Crohn's Disease

Abstract

A 38-year-old woman with documented Crohn's disease (CD) had uniocular nodular episclerrtis and a limbal nodule with surrounding infiltrate, which, when healed, left residual pannus. The episcleral nodule was abnormally large (7x5x3 mm). A localized conjunctiva! ulcération, a rare manifestation, to our knowledge not previously reported, developed later in the same eye. Impression cytology of the ulcer showed pyknotic conjunctival epithelium and absence of goblet cells, together with the presence of a few plasma cells, lymphocytes, and macrophages. These features are comparable to those seen in the intestinal mucosa of patients with CD. The unilaterality of the ocular infection together with the good response to local therapy suggests that a local antigen-antibody immune complex reaction was involved. We recommend local therapy as a first treatment option.

Ulcerated conjunctival mass as an initial presentation of idiopathic orbital inflammatory disease: a case report

“…Ocular surface tumors may present as either melanotic or non-melanotic conjunctival mass, which can undergo ulcerative changes. 7 Conjunctival ulcers are seen in autoimmune disorders (such as Behcet's disease 8 and Crohn's disease 9 ) and in infections (such as tuberculosis and herpes simplex). 10 Although there are no prior reports of ulcerative conjunctival lesions in IOID or IgA nephropathy, autoimmune diseases (such as Crohn's disease, systemic lupus erythematosus, sarcoidosis, rheumatoid arthritis, and ankylosing spondylitis) are associated with IOID.…”

A case study of benign nodular episcleritis and management

“…25,26 Rare manifestations of ulcers have also been stated after surgery of cataract extraction, which showed effectiveness with corticosteroid therapy. 27…”