Bilateral infection-triggered ligneous conjunctivitis in a 6-month-old patient treated successfully with heparin and allogenic serum eye drops

Purpose To report a case of successful management of ligneous conjunctivitis (LC) in a pediatric patient. Methods We report the case of a 6-month-old girl presenting with persistent thick membranes on the palpebral conjunctiva after an initial episode of infectious conjunctivitis. Results Complete resolution of symptoms was achieved after 4 months of treatment with commercially available heparin-containing artificial tears and allogenic serum drops obtained from maternal blood. Genetic testing later revealed a homozygous pathologic variant of the plasminogen gene (PLG) confirming diagnosis of plasminogen deficiency with associated LC. Clinical remission was sustained 10 months after allogenic serum cessation. Conclusions LC with ocular membrane formation is the most common clinical presentation in patients with type I plasminogen deficiency. The fibrin rich membranes can lead to sight threatening complications and reduced quality of life. This is a report of full resolution of ocular membranes in LC after a corticosteroid sparing treatment combining heparin-containing artificial tears and allogenic serum eye drops in a pediatric patient.