A 60-year-old man presents with progressive bilateral peripheral corneal ulceration with an overhanging central edge and absent corneal vascularisation. He has no systemic autoimmune disease. The ulcer progresses circumferentially. Which pathological process is primarily responsible for Mooren's ulcer?
- A Autoantibodies against corneal stromal antigens with T-cell mediated destruction ✓
- B Type III hypersensitivity reaction with immune complex deposition
- C Direct bacterial invasion of the corneal periphery
- D Neurotrophic mechanism from trigeminal nerve dysfunction
Correct answer: A. Autoantibodies against corneal stromal antigens with T-cell mediated destruction
Explanation
Mooren's ulcer is an autoimmune peripheral ulcerative keratitis where autoantibodies target corneal stromal antigens, with CD4+ T-cells and macrophages mediating stromal destruction. It is not infectious. Type III hypersensitivity describes immune complex vasculitis seen in systemic autoimmune PUK. Neurotrophic ulcers lack the inflammatory, overhanging edge.
Reference: Basic and Clinical Science Course, Section 8: External Disease and Cornea, AAO 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.