Corneal Mucous Plaques Clinical Presentation

Updated: Jun 14, 2016
  • Author: Robert H Graham, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Presentation

History

Symptoms associated with corneal plaques include blurred vision, foreign body sensation, and marked pain.

Except when severe, these symptoms are often indistinguishable from those of herpes zoster, keratitis, overwear of contact lenses, and keratoconjunctivitis sicca, with or without concomitant Sjögren syndrome, rheumatoid arthritis, or other collagen vascular diseases.

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Physical

Multiple plaques are common and are frequently bilateral. When a plaque has adhered to the cornea, it remains for a few days or weeks; recurrences may appear but are seldom in the same location. Thickened plaques with a dry surface may appear elevated well above the tear film and may even cause dellen formation.

Other associated findings include the following:

  • Chronic blepharoconjunctivitis

  • Blepharospasm

  • Ciliary or conjunctival injection

  • Conjunctival mucoid discharge

  • Conjunctival filaments

  • Filamentary keratitis

  • Decreased corneal sensation

  • Mild iritis with or without keratic precipitates

  • Corneal epithelial and stromal edema in association with herpes zoster keratitis [2, 3]

  • Corneal epithelial defects

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Causes

Corneal mucous plaques occur primarily in patients with keratoconjunctivitis sicca, but they also may be seen with herpes zoster, vernal keratoconjunctivitis and other forms of keratitis, and after local radiation exposure. [2, 4, 5]

Delayed plaques and pseudodendrites associated with herpes zoster also may be infectious because they are positive for zoster DNA by polymerase chain reaction. [6]

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