Pseudomembrane to nodule-gamut of ligneous conjunctivitis: A case report

Ligneous conjunctivitis is a type of chronic conjunctivitis characterized by the presence of pseudomembranes on the conjunctival surface. It can present as a part of a multisystem disease with involvement of other mucous membranes. A 1-year-old girl presented with features of conjunctivitis. Local examination revealed thick exudates in left tarsal conjunctiva, which was diagnosed as an ulcer with pseudomembrane and sterile culture. The patient presented with a nodular mass in the same site after a year, which showed a pseudomembrane along with sub-epithelial hyaline lobular deposits negative for Congo red, concurring a diagnosis of ligneous conjunctivitis. The patient was prescribed topical lubricating agents and regular follow up. Ligneous conjunctivitis is attributed to a deficiency of plasminogen, which plays a vital part in wound healing. The present case highlights the progression of pseudomembrane into a ligneous lesion in a child who was resisting medication and follows up.