Abstract
To the Editor. —Retinoic acid has improved clinical signs in most cicatrizing dry eye conditions, but not in keratoconjunctivitis sicca.1Even in the absence of cicatrization, it has produced a substantial improvement in some cases of conjunctival and corneal keratinization.2We found that ocular surface keratinization was predictive of response to topical retinoic acid treatment in the course of a randomized, double-masked, placebo-controlled, crossover trial. We quantified conjunctival and corneal keratinization by dividing the ocular surface into 11 zones and scored each area from 0 (no keratinization) to 3 (thick keratin plaque), based on slit-lamp examination and rose bengal staining. The numbers were added to determine a total clinical keratinization score. Conjunctival scrapings were Giemsa stained; an average of 200 to 300 epithelial cells were randomly counted from areas of each slide to determine the percentage of keratinized cells and keratinizing epithelial cells. Report of a Case. —A
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