Like in other anatomic sites, a caseating necrotising granulomatous infection can be caused by tuberculosis, especially in children [32, 45, 76].
Ligneous conjunctivitis (chronic pseudomembranous conjunctivitis) is a rare bilateral disease, mainly occurring in young girls. It presents as a subacute inflammation of the tarsal conjunctiva, often accompanied by nasopharyngitis and vaginitis. The disease seems to be due to a defective fibrinolysin system. Microscopically, granulation tissue is present, covered with plaques of fibrinous material, later forming a hyalinised mass. After removal of the plaque, recurrence is common. It can be complicated by corneal involvement and perforation with loss of the eye may occur [15, 17, 99].
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