CHRONIC PROGRESSIVE CONJUNCTIVAL CICATRIZATION

The aim of this review is to demonstrate the spectrum of conditions en compassed by the term 'chronic progressive cicatrising conjunctivitis' , to discuss mechanisms of conjunctival scar tissue formation and to d escribe the sequelae and therapeutic options in this potentially blind ing condition. Chronic progressive cicatrising conjunctivitis is found in association with some mucocutaneous disorders (cicatricial pemphig oid, linear IgA disease), as part of paraneoplastic syndromes and afte r long-term treatment with certain systemic and topical medications (p seudo-pemphigoid). Recent studies on the conjunctiva of pemphigoid pat ients indicate that macrophages may play a pivotal role in chronic pro gressive conjunctival cicatrisation. They mediate the transition from inflammation to scar tissue by secretion of fibrogenic cytokines. Ther e is evidence that similar mechanisms are involved in the other fibros ing conjunctival disorders. Sequelae of chronic conjunctival cicatrisa tion include the obstruction of lacrimal and meibomian glands, tear fi lm alterations, trichiasis, keratopathy and blindness. Present possibi lities and future options for the treatment of this condition are disc ussed.