Pathological Keratinization of Ocular Surface Epithelium

The normal ocular surface is composed of corneal, limbal, and conjunctival epithelial cells, which maintain its integrity. Severe damage to limbal epithelial cells from Stevens-Johnson syndrome (SJS), ocular cicatricial pemphigoid (OCP) and chemical burns may lead to loss of the limbal epithelial cells.1 Such limbal cell deficiencies are some of the greatest challenges facing todays clinician.2–6 During the chronic cicatricial phase, most patients with ocular surface disease—experience numerous problems, including symblepharon, persistent epithelial defects, conjunctivalization, and pathological keratinization. Some of these problems can be managed by antibiotics, corticosteroids and immunosuppressants. However, the pathological keratinization of ordinarily nonkeratinized corneal and conjunctival epithelium is a serious and potentially debilitating problem that is difficult to manage pharmacologically.