MAR 15, 2016
Shield Ulcer Surgical Treatment
AAO 2015
Cornea/External Disease
An 11-year-old patient had a left-eye shield ulcer unsuccessfully treated with topical steroids and antibiotics for 2 months. At presentation, he had left-eye hyperemia, tearing, photophobia, best-corrected visual acuity (BCVA) of 20/60, and superior corneal epithelial defect covered by a plaque of fibrin (3.7 × 4.8 cm). The plaque extends below the hypertrophic epithelial borders of the ulcer, so the surgical approach included breakage of the surrounding epithelium and careful lifting and peeling of the plaque. The left eye was patched with dexamethasone 1% and neomycin sulphate ointment. Complete epithelialization occurred within 1 week. After 1 month, BCVA was 20/40, the left was quiet, and the patient was asymptomatic.