To the Editor.
—Retinoic acid has improved clinical signs in most cicatrizing dry eye conditions, but not in keratoconjunctivitis sicca.1 Even in the absence of cicatrization, it has produced a substantial improvement in some cases of conjunctival and corneal keratinization.2 We 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.
Herbort CP, Weissman SS, Ostler HB, Cevallos A, Char DH. Ocular Surface Keratinization as a Predictor of Response to Topical Retinoic Acid Therapy. Arch Ophthalmol. 1989;107(9):1275-1276. doi:10.1001/archopht.1989.01070020345002