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Chapter-43 Management of Mooren\'s Ulcer

BOOK TITLE: Surgical Techniques in Ophthalmology: Corneal Surgery

Author
1. Sharma Ashok
ISBN
9788184488579
DOI
10.5005/jp/books/11369_43
Edition
1/e
Publishing Year
2010
Pages
3
Author Affiliations
1. Dr Ashok Sharma’s Cornea Centre, Sector 22-A, Opp. Parade Ground, Near Bus Stand, Chandigarh, India, Dr Ashok Sharma’s Corneal Centre, SCO 833-834, 2nd Floor, Sector 22-A, Chandigarh, India, Cornea Centre, SCO 833-834 (2nd Floor), Sector 22-A, Near Bus Stand, Opp Parade Ground, Chandigarh, India, Dr. Ashok Sharma’a Cornea Centre, SCO 833-34 (2nd Floor), Sector 22-A, Opp. Parade Ground, Near Bus Stand, Chandigarh, India, Dr Ashok Sharma’s Cornea Centre, Chandigarh, India, Dr. Ashok Sharma’s Corneal Centre, SCO 833-834 (2nd Floor), Sector 22-A, Chandigarh, India, Dr. Ashok Sharma’s Cornea Center, SCO 833-34 (2nd Floor), Sector 22-A Opp. Parade Ground, Near Bus Stand, Chandigarh, India, Malhotra Test Tube Baby Centre, Agra, Indra Gandhi Medical College, Shimla, Himachal Pradesh, India, Scientific Pathology Laboratories, Agra, Uttar Pradesh, India, Dr Ashok Sharma’s Cornea Centre, SCO 833-834, IInd Floor Sector 22-A, Chandigarh, India
Chapter keywords
Mooren’s ulcer, peripheral corneal ulceration, corneal stroma, peripheral ulcerative keratitis, corneal epithelial defect, vascularization of the cornea, repeat peritectomy

Abstract

Mooren’s ulcer is a chronic, bilateral, progressive, painful, peripheral corneal ulceration. The disease progresses circumferentially initially, radially towards center and into the deeper corneal stroma at later stage of the disease. Several predisposing factors including previous trauma, history of surgical procedure and infections are found to be associated with the onset of the disease. The exact etiopathogenesis remains unknown. Autoimmune mechanisms are postulated to be the underlying cause of the disease. The diagnosis of Mooren’s ulcer is based on its classical clinical appearance and exclusion of various systemic disorders associated with development of peripheral ulcerative keratitis. All patients suffering from Mooren’s ulcer should be subjected to detailed microbiological work up. In case a micro-organism is isolated, broad spectrum antibiotic should be given. The mainstay of the treatment is oral corticosteroids. Topical steroids, topical antibiotic and cycloplegic are prescribed in all cases. The resolution of the corneal infiltrate and healing of corneal epithelial defect indicate that the Mooren’s ulcer is responding. Patients developing vascularization of the cornea approaching the margin of the ulcer should be considered for repeat peritectomy, otherwise the patient will develop recurrence of the disease.

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