An Unusual Mooren's Ulcer.

MOOREN'S ulcer (chronic serpiginous ulcer) of the cornea is described as a superficial corneal ulcer usually occurring in the elderly and eventually spreading over the whole corneal surface. Associated features are pain and lacrimation; iritis may occur and rarely a hypopyon (Duke-Elder, 1959). Initially one or more grey peripheral infiltrates occur; these ulcerate and coalesce. Undermining of the corneal epithelium and superficial lamellae is responsible for the characteristic over-hanging whitish edge. Progress occurs circumferentially and towards the centre. There is minimal inflammatory reaction with epithelialization of the undermined edge and crater (Hogan and Zimmerman, 1962) followed by vascularization of the ulcer base. Perforation never occurs (Duke-Elder, 1959). Progression with intermissions is the rule until the whole cornea is a thin nebula with corresponding diminution of vision. In one quarter of cases both corneae are involved, but not always simultaneously (Duke-Elder, 1959). The aetiology is unknown. The following case report records an unusual, and initially perplexing presentation, and the subsequent management.