Parotid duct transposition in xerophthalmia. Report of a case.

Abstract

THE treatment of xerophthalmia has posed a difficult problem of management for the ophthalmologist. This condition may follow as the incapacitating sequela of Stevens-Johnson syndrome, trachoma, exfoliative dermatitis, or ocular pemphigus. Manifestations of the disease include severe, necrotizing conjunctivitis with corneal ulceration and secondary iritis, followed by widespread conjunctival and corneal scarring. Photophobia and blepharospasm may be profound. The final picture is characterized by lacrimal deficiency, epidermalization of the lining of the eye with more or less extensive symblepharon and severe visual impairment. The usual conservative therapeutic measures consist of instillation of artificial tears, administration of vitamin A and the use of a moist chamber. Unfortunately, these efforts often prove unsatisfactory, requiring utilization of more radical measures. Tarsorrhaphy can be employed with effective temporary improvement. Occlusion of the lacrimal puncta has also been suggested. Transplantation of various tissues into the conjunctiva such as oral mucosa and placenta 1 have been