Aggressive glioma of adulthood simulating ischemic optic neuropathy.

opsy was also performed in the left inferior conjunctival fornix of the mother’s eye to exclude ocular cicatricial pemphigoid. The biopsy specimen showed a nonspecific monocytic infiltration and epithelial squamous metaplasia. Direct immunofluorescence results were negative for IgG, IgM, IgA, and complement factors (C3 and C4). As expected, magnetic resonance imaging showed marked hypoplasia or agenesia of the lacrimal glands in the mother. A corneal impression cytology test was performed in both patients and periodic acid–Schiff staining (Sigma Diagnostics, St Louis, Mo) showed the presence of epithelial squamous metaplasia and goblet cells on their corneal surfaces. (Figure 1B) Immunohistochemistry demonstrated the absence of cytokeratin K3 positive cells and the presence of cytokeratin K19 positive cells in their corneas (Figure 1C and D).