The corneal melting syndrome of Mooren (also referred to as Mooren's ulcer) occurs as a result of immune activation.
Features:
(1) underlying autoimmune disorder, including viral hepatitis C
(2) triggering event (cataract surgery, chemical splash to the eye, trauma)
(3) rapidly progressive keratitis of one or both corneas
(4) exclusion of other causes of keratitis
Features of the corneal keratitis:
(1) The process is painful and associated with impaired vision.
(2) The keratitis is destructive with eventual ulceration.
(3) The process usually starts in the periphery and becomes circumferential.
(4) There is an overhanging inner edge and neovascularization.
(5) With progression there is involvement of the central cornea and loss of corneal stroma.
(6) Some patients may develop a scleritis.
Immunosuppression prior to surgery may avoid recurrence of Mooren's ulcer.
