Bilateral Keratoconjunctivitis Associated with Lichen Planus

Purpose: To describe a case of bilateral keratoconjunctivitis in a patient with lichen planus. Methods: Case report and review of the English literature. Results: To our knowledge, this is the fourth reported case of keratoconjunctivitis associated with lichen planus. A 33-year-old Navajo man with lichen planus had recurrent and progressive keratoconjunctivitis that failed to improve on multiple topical medications. Tapered oral prednisone, 2% topical cyclosporin, and amniotic membrane transplantation pacified the acute exacerbation. Conclusions: Our patient with lichen planus developed an ocular surface disease with cicatricial conjunctivitis, keratouveitis, keratoconjunctivitis sicca, punctate epithelial erosions, and persistent epithelial defects leading to noninfectious or infectious corneal ulceration. Amniotic membrane transplantation may play an adjunctive role in refractory cases of lichen planus-related keratoconjunctivitis. Topical cyclosporin may stabilize the ocular surface when combined with systemic immunosuppression in severe cases.