case_images: PMC11319060_01
case_images: Shield ulcer on the left eye.
case_images: CRIOPM2024-9973441.001.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.001.jpg
case_images: fig1
case_images: The ophthalmological evaluation revealed the presence of giant papillae (GP) in both eyes, leading to the formation of a shield ulcer in the left eye (Figure 1).
case_images: (a) Right eye. (b) Left eye.
case_images: CRIOPM2024-9973441.002.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.002.jpg
case_images: fig2
case_images: However, in the third year, the patient experienced a worsening of symptoms with the presence of large cobblestones during the examination (Figure 2).
case_images: Mechanical ptosis on both eyes.
case_images: CRIOPM2024-9973441.003.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.003.jpg
case_images: fig3
case_images: After a year, there was a recurrence of symptoms with gradual enlargement of papillae (Figure 3), leading to chronic irritation despite topical antihistamine and steroid.
case_images: Cobblestones progressivity on superior tarsal of the right eye, on year.
case_images: CRIOPM2024-9973441.004.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.004.jpg
case_images: fig4
case_images: Additionally, the patient exhibited giant cobblestones causing pseudoptosis (Figures 4 and 5), along with an increase in astigmatism in the refractive measurements.
case_images: Cobblestones progressivity on superior tarsal of the left eye, on year.
case_images: CRIOPM2024-9973441.005.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.005.jpg
case_images: fig5
case_images: Additionally, the patient exhibited giant cobblestones causing pseudoptosis (Figures 4 and 5), along with an increase in astigmatism in the refractive measurements. Following the surgical intervention, the clinical monitoring revealed a relatively smooth upper tarsal conjunctiva throughout the 2-year follow-up period (Figure 5).
case_images: Surgical steps on the right eye; giant papillae were excised, and autologous conjunctival membrane was grafted and sutured directly onto excised tarsus.
case_images: CRIOPM2024-9973441.006.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.006.jpg
case_images: fig6
case_images: Subsequently, a subconjunctival injection of dibekacin (40 mg/mL) and dexamethasone was given, followed by placement of a bandage soft contact lens (Figures 6 and 7).
case_images: Surgical steps on the left eye; giant papillae were excised, and autologous conjunctival membrane was grafted and sutured directly onto excised tarsus.
case_images: CRIOPM2024-9973441.007.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.007.jpg
case_images: fig7
case_images: Subsequently, a subconjunctival injection of dibekacin (40 mg/mL) and dexamethasone was given, followed by placement of a bandage soft contact lens (Figures 6 and 7).
case_images: Right eye, post combined papillectomy and autologous conjunctival membrane graft: (a) 10 days; (b) 2 months; (c) 6 months.
case_images: CRIOPM2024-9973441.008.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.008.jpg
case_images: fig8
case_images: Bandage soft contact lenses were worn for a minimum of 7 days to aid in the healing process (Figures 8 and 9).
case_images: Left eye, post combined papillectomy and conjunctival membrane graft: (a) 10 days; (b) 2 months; (c) 6 months.
case_images: CRIOPM2024-9973441.009.jpg
case_images: PMC11319060_01_CRIOPM2024-9973441.009.jpg
case_images: fig9
case_images: Bandage soft contact lenses were worn for a minimum of 7 days to aid in the healing process (Figures 8 and 9).