Marginal corneal ulcers may occur in patients with rheumatoid arthritis, especially if the patient has associated Sjogren's syndrome and sever tearing abnormalities.  This peripheral ulceration may progress to frank corneal perforation.  Histopathologically, the area of perforation is characterized by a sterile necrosis or melting of corneal stroma with progressive thinning and eventual perforation.  The corneal stroma is necrotic and shows signs of melting with a moderate, chronic mononuclear cell infiltrate(#22195, #22196).