Rev Bras Oftalmol.2026;85:e0079
Mooren’s ulcer after pterygium excision: case report with serial anterior segment optical coherence tomography documentation
DOI: 10.37039/1982.8551.20260079
ABSTRACT
This study shows a case report of Mooren’s ulcer with a presumptive diagnosis, established by exclusion, occurring after pterygium surgery in a young patient with preexisting cutaneous autoimmune disease. This case report was based on comprehensive clinical evaluation, laboratory testing, microbiological cultures, PCR for infectious agents, and serial AS-OCT documentation, with the purpose of excluding known infectious and systemic etiologies. Therapeutic management included fortified antibiotics, tectonic support with a therapeutic contact lens and fibrin glue, followed by systemic immunosuppression after exclusion of these causes. The patient developed a progressive peripheral corneal ulcer with significant thinning after pterygium excision. Laboratory and microbiological investigations were negative, and AS-OCT enabled objective monitoring of stromal thinning. After initiation of prednisone and methotrexate, there was structural and functional recovery, with complete resolution of the lesion and a final visual acuity of 20/20. This case illustrates a possible association between surgical trauma and Mooren’s ulcer, emphasizes the importance of clinical diagnosis by exclusion, and demonstrates the role of AS-OCT in follow-up and support for therapeutic decision-making.
