MOOREN’S ULCER –A CASE REPORT

Abstract

Introduction: Mooren’ s ulcer is a painful, relentless, chronic ulcerative keratitis that starts peripherally and progresses circumferentially and centrally. Mooren’s ulcer is a rare corneal ulcer and it is important to be recognized early and treated properly. The different clinical symptoms and local sings and presentation (unilateral or bilateral) of corneal Mooren’s ulcer, separate this entity in two groups, benign-limited form and aggressive or progressive form with severe symptoms and morbidity, high tendency for recurrence and increased risk of unsuccessful treatment. Case presentation: A case of Mooren’s ulcer in a female patient 65-year-old is present. She was treated at the University Clinic for eye disease in Skopje after one month of leech extraction of her left eye. The patient came at the Clinic as urgent case with melting syndrome of the peripheral left cornea. Slit lamp examination of the anterior segment confirm the Mooren’s ulcer clinical characteristic such as crescent-shaped, peripheral half-circumferential corneal ulcer which start from the limbus with gray infiltrated margin. The sclera around was not involved. The patient complained of pain in her eye and blurred vision. Red eye, foreign body sensation and epiphora were present also. Corneal and conjunctival culture was taken. The lacrimal canal was examined with the straight lacrimal cannula on a 3 ml saline –filled syringe inserted into the lower canaliculus. There was no obstruction in the upper or lower or the common canaliculus. The lacrimal canaliculus was without secretion. Conclusion: A proper, rigorous and early treatment of the Mooren’s ulcer is important for improvement of the local status of this peripherally circumferential melting syndrome. The leech extraction from the patient left eye, a month before, maybe is one of the key factors in the pathogenesis of Mooren’s ulcer.