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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.

The patient presented with corneal edema and descemet's folds. The patient noted that she was gardening, and the offending contact was likely euphorbia cyparissias plant sap.

Post penetrating keratoplasty for candida keratitis, this patient developed another foci of infection within the graft tissue. Stromal vascularization and edema can be seen indication failure of the graft.

Keratoprosthesis infiltrate and epithelial defect. There was progression with pain and and vitritis that led to removal of the prosthesis.

This patient underwent uneventful cataract surgery. On post-operative day 1 there was found to be a fragment of metal on the iris likely from the phacoemulsification probe.

Inferior peripheral corneal thinning due to systemic inflammatory disease. Surgery was with conjunctival recession and amniotic membrane placement.