Mooren's Ulcer (Chronic Serpiginous Ulcer)

Definition:
Mooren's ulcer is strictly a peripheral ulcerative keratitis (PUK) with no associated scleritis.

Clinical Features:

1. It commences as one or more grey infiltrates which break down to form small
   spreading ulcers which eventually coalesce. The ulcer undermines the epithelium
   and superficial lamellae at the advancing border, forming a characteristic
   overhanging edge, the base becoming vascularized.
2. Erosion of the epithelium is accompanied by pain and watering of the eye.
3. Perforation is rare but intermittent progression over several months is usual until a
   thin nebula forms over the whole cornea with diminution of sight.
4. In about 25% of cases both corneae are affected but not always simultaneously.

Exact aetiology is unknown. It is suspected to be a degenerative condition.

Treatment:

1. Topical steroids
2. Conjunctival resection
3. Systemic immunosuppressives
4. Additional surgical procedure
5. Rehabilitation