A conjunctival scraping was negative for microorganisms (Gram stain) and chlamydia (Giemsa stain); there was no culture growth. Plasminogen enzyme activity was depressed (12%; normal, 75%-125%). A membrane peel was performed (see below), and histopathology demonstrated a plaquelike, laminated fibro-inflammatory psuedomembrane with scattered neutrophils and other inflammatory cells (Figure 2). The low plasminogen enzyme activity and the appearance of the palpebral conjunctival epithelium, with organizing neovascular ingrowth, was consistent with ligneous conjunctivitis.
Figure 2
Amorpohous fibrinous material (broken arrow) and infiltrating inflammatory cells (straight arrow) in pseudomembrane tissue (hematoxylin-eosin, original magnification ×40).
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