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Peripheral Ulcerative Keratitis A patient with well-controlled HIV on antiretroviral therapy presented to the emergency department with five months of left eye pain, redness, discharge, and blurry vision. Visual acuity in the left eye was found to be 20/60 and slit lamp examination was remarkable f…

Limbal Stem Cell Deficiency We report a case of severe unilateral chemical-thermal injury complicated by total limbal stem cell deficiency and symblepharon, treated with Simple Limbal Epithelial Transplantation (SLET) combined with conjunctival autografting (CAG). We used an autologous limbal biops…

Crystalline Keratopathy Secondary to Mycobacteria Abscesses in Setting of Pre-Existing Herpetic Keratitis A patient with history of herpetic keratitis referred to cornea service with multifocal, white, anterior stromal deposits left eye. Examination revealed 20/20 with inferior and temporal paracen…

Conjunctival Amyloidosis A 48-year-old male with no PMH or POH presented to clinic with painless ptosis OD>OS noticed by his wife for several months. Visual acuity was 20/25 in each eye with unremarkable ocular vitals. Large, yellow-pink, fleshy lesions were noted on the superior bulbar conjunct…

Scleral-Invasive Ocular Surface Squamous Neoplasia An 83-year-old male with history of skin cancer and tobacco use was referred to BPEI for evaluation of a subconjunctival mass which was previously biopsied. On presentation, a large firm subconjunctival mass with prominent feeder vessels was seen. …

Pythium Insidiosum Keratitis An 83-year-old otherwise healthy female was referred to the BPEI ER for a progressive corneal ulcer. Exam in the left eye was notable for hand motions vision, normal IOP, and severe corneal ulcer associated with hypopyon and scleral extension. B-scan ultrasonography of …

Gonococcal Preseptal Cellulitis, Gonococcal Conjunctivitis A 21-year-old female presented to the hospital with 5 days of right eye redness, swelling, discharge and pain. Exam revealed VA OD 20/70, painful EOM and severe conjunctival chemosis and discharge, and eyelid swelling. CT scan revealed righ…

Ocular Surface Squamous Neoplasia A 71-year-old male with a history of atopic dermatitis was referred to BPEI for evaluation of a corneal lesion. Exam revealed an opalescent and gelatinous lesion at 2-4 o'clock at the limbus in the left eye. Anterior segment OCT showed a thickened, hyperreflective …

Erdheim Chester Disease A 37-year-old male presented to clinic with bilateral conjunctival lesions for 7 months. Patient has a history of lytic bone lesions, 50-pound weight loss, and fevers. Examination revealed 20/20 vision in both eyes, mobile, discrete conjunctival lesions in bilateral bulbar c…

Lattice Corneal Dystrophy Lattice corneal dystrophy is a rare disease with a variety of etiologies. Historically, corneal dystrophies have been defined as bilateral, progressive processes that start in a patient’s first to second decade of life and have no correlation with systemic illnesses. Whi…

Granulomatosis with Polyangiitis This presentation describes a case of granulomatosis with polyangiitis in which ocular disease (scleritis) led to the diagnosis. The patient subsequently developed scleral melt with uveal show, requiring a multidisciplinary approach with Rheumatology to escalate imm…

Sebaceous Carcinoma Presenting with Corneal Ulcer and Descemetocele An 87-year-old male was referred for second opinion due to nonhealing corneal ulcer of his right eye. He had a past medical history significant for basal cell carcinoma, arthritis, hypertension, hypothyroid, CABG, and carotid stent…

In this module, we will look at:




Conjunctiva


Sclera

In this module, we will look at:




Corneal Anatomy


Refractive Errors


Dry Eye Syndrome


Corneal Infections


Immune Mediated Corneal Disease



Corneal Ectasias and Degenerations

White linear radial stromal haze caused by infiltration and inflammation of the corneal nerves by the amoeba.

The bee stinger seen in the cornea has remained stable for many years and not affected the vision or required removal.

Slit lamp photo post LASIK surgery 2 months prior showing patches of cellular material in the the cornea, worse inferiorly. The anterior segment OCT demonstrates the level of the ingrowth is in the interface of the flap.