|Year : 1969 | Volume
| Issue : 3 | Page : 114
Topical cortisone in the treatment of Mooren's ulcer
Patna Medical College and Hospital, Patna, India
|Date of Web Publication
Patna Medical College and Hospital, Patna
Source of Support: None, Conflict of Interest: None
|How to cite this article:
Pandey R. Topical cortisone in the treatment of Mooren's ulcer. Indian J Ophthalmol 1969;17:114
Mooren's ulcer was originally described by Mooren in 1867 as a chronic superficial ulcer of unknown aetiology, occurring in elderly people which has a characteristically undermined border and does not perforate.
The author came across four such cases of Mooren's ulcer, three in the indoor wards of Patna Medical 'College Hospital and one in the author's private clinic. In the former three cases cauterizing with heat and carbolic acid, local antibiotic ophthalmic ointments, injections of high doses of vitamins C, B1 and B12 were administered. The ulcers were covered by a conjunctival flap after removal of the overhanging corneal edge. In spite of these vigorous measures, all the three eyes were ultimately lost.
| Case Report
On 9.4.67 the author came across Mr. B. Singh, male, aged 40 years with a typical Mooren's ulcer in the right eye. Before this, the patient had been treated by topical sulphacetamide drops and tetracycline eye ointments along with topical atropine and bandaging of the right eye for over a month, in his own village, but to no effect.
The author performed a lateral tarsorraphy in the right eye on 9.5.67
The pain redness photophobia, lacrimation and some amount of itching in the eye recurred off and on and brought the patient under the author's observation whenever there was recurrence. Systemic cortisone was also used in this case with no effect. This patient was referred to another ophthalmic surgeon who treated him by repeated carbolic cautery, which also proved ineffective.
Ultimately on 18.4.68 he was treated by cortisone ophthalmic ointment (Betnasol eye ointment of Glaxo) thrice daily, particularly because the patient complained of some amount of itching along with profuse watering of the eyes and severe pain along the ophthalmic division of the 5th nerve. After a week's treatment on topical cortisone ointment the patient was completely relieved of all his symptoms. The tarsorraphy was undone and the patient went home. Since three months there have been no recurrences, although he is getting no medicines. This shows that topical cortisone was the only effective measure in this case of Mooren's ulcer.
Leigh  has reported one case of Mooren's ulcer which responded to systemic cortisone, but he has also reported that topical cortisone has been used extensively in Mooren's ulcer without any effect.
A case of Mooren's ulcer treated unsuccessfully with cauterization, systemic and local antibiotics and tarsorraphy, responded immediately to local applications of dexamethasone. A significant symptom was itching which suggested local therapy with corticosteroids.
Leigh A.G.: XIX Concillum Ophthalmologicum Acta Vol. 1, 1962, New Delhi.