October consultation #4

Given the history and figures, my first diagnosis would be superior limbic keratoconjunctivitis secondary to the left upper lid lesion. Certainly, I would also excise the verrucous growth of the left upper lid, and I would send the specimen for pathology and HPV detection. I would initiate main therapy according to the pathology of the lid lesion (eg, if HPV-positive, topical IFN α2b and retinoic acid or topical cidofovir have been recommended1; adding oral cimetidine might also be helpful2). For treatment of recurrent erosion of cornea, I would perform epithelial debridement with the use of a diamond burr to polish the surface of the cornea and BCL in association with topi cal antibiotics and steroids as well as a low-dose oral doxycycline.
Source: Journal of Cataract and Refractive Surgery - Category: Opthalmology Authors: Tags: Consultation section: Cataract Source Type: research