A Case of Conjunctival Lithiasis with Clinical Manifestations of Superior Limbic Keratoconjunctivitis

Bo Kwon Son; Chan Min Yang; Tae Gi Kim; Kyung Hyun Jin

doi:10.3341/jkos.2016.57.6.983

Journal List > J Korean Ophthalmol Soc > v.57(6) > 1010619

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Son, Yang, Kim, and Jin: A Case of Conjunctival Lithiasis with Clinical Manifestations of Superior Limbic Keratoconjunctivitis

Case Report

J Korean Ophthalmol Soc 2016;57(6):983-987.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.6.983

A Case of Conjunctival Lithiasis with Clinical Manifestations of Superior Limbic Keratoconjunctivitis

Bo Kwon Son, MD, Chan Min Yang, MD, Tae Gi Kim, MD, Kyung Hyun Jin, MD, PhD

Department of Ophthalmology, KyungHee University Hospital, KyungHee University School of Medicine, Seoul, Korea

Address reprint requests to Kyung Hyun Jin, MD, PhD Department of Ophthalmology, KyungHee University Hospital, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340 E-mail: khjinmd@khmc.or.kr

Received 20 August 2015 Revised 28 October 2015 Accepted 30 December 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of conjunctival lithiasis with clinical manifestations of superior limbic keratoconjunctivitis.

Case summary

A 40-year-old male complained of pain, foreign body sensation and injection in the left eye lasting 1 month. The slit-lamp examination revealed injection of the superior bulbar conjunctiva, linear corneal band opacity, fine punctate staining and epithelial defect in the superior cornea area. After eversion of the left upper eyelid, there were many various-sized conjunctional concretions and inflammation in the superior tarsal conjunctiva. Therefore, we considered conjunctival lithiasis-induced clinical manifestations of superior limbic keratoconjunctivitis and then removed the conjunctival concretions using a 30-gauge needle. After the procedures, artificial tears, antibiotic eye drops, steroid eye drops and a therapeutic contact lens were applied. After 1 week, all symptoms and signs improved and there was no recurrence for 4 months.

Conclusions

Mechanical stimulation by severe conjunctival lithiasis can induce clinical manifestations of superior limbic keratoconjunctivitis. Therefore, in patients with clinical manifestations of superior limbic keratoconjunctivitis, conjunctival lithiasis should be considered by observing the superior tarsal conjunctiva more closely.

Keywords: Conjunctival lithiasis, Superior limbic keratoconjunctivitis

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Figure 1.

Slit lamp photographs of the left eye at initial presentation. There are superior sectoral bulbar conjunctival injection (arrow) (A), a linear corneal band opacity (arrow) (B), a fine punctate staining and epithelial defect (arrow) (C). Multiple vari-ous-sized concretions and Inflammation are observed on the superior tarsal conjunctiva (arrow) (D).

Figure 2.

Slit lamp photographs of the right eye at initial presentation. There is no specific abnormalities in the cornea and conjunctiva (A). Very few concretions are observed on the superior tarsal conjunctiva (arrow) (B).

Figure 3.

Slit lamp photographs of the left eye at 4 months. Superior bulbar conjunctival injection disappeared (arrow) (A). A linear band opacity (arrow) (B), punctate epithelial erosions improved and epithelial defect completely recovered (arrow) (C). Most of concretions were eliminated and inflammation resolved on the superior tarsal conjunctiva (arrow) (D).

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