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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.

Peripheral crescentic ulceration and thinning along limbus from 0600 to 1200 with superior neovascularization associated with pain. Treatment was initially with lubrication, antibiotic, systemic steroids, vitamin C, and doxycycline. Ultimately, the patient needed conjunctival recession with AMT pla…

Patient with history of multiple retinal detachments with a phthisis eye. The crystalline lens is noted to have migrated external to the sclera and subconjunctivally.

Conjunctival Amyloid Conjunctival amyloid is an uncommon ocular finding but important to consider in the differential of conjunctival lesions. We present a case of a patient who was referred for evaluation of a potential ‘malignant’ conjunctival tumor. On exam she was found to have a yellow, mo…

Iridocorneal Endothelial Syndrome (ICE) A 27-year-old woman presented for corneal evaluation with a history of secondary glaucoma. She was found to have iridocorneal endothelial syndrome (ICE). She underwent DSAEK, which failed after 13 months. Subsequent Type 1 Boston Keratoprosthesis was successf…

Peters Anomaly Type 1 A 2-week-old girl presented with bilateral Type I Peters anomaly consisting of bilateral dense central corneal opacities and iridocorneal adhesions. Upon presentation patient had elevated IOP in both eyes (OU) (38 mmHg in the right eye (OD) and 40 mmHg in the left eye (OS)), w…

Conjunctival Squamous Cell Carcinoma with Intraorbital and Intraocular Invasion A 64-year-old male with a history of T2DM and HTN was referred for 2 weeks of severe pain and redness in the right eye. Two months earlier, he had undergone reported pterygium removal surgery in another country. At pres…

Severe Ocular Chemical Injury A 41-year-old male international patient presented to BPEI 2 months after the initial injury with persistent redness and decreased vision. Clinical exam revealed scleral melt and ischemia and the patient was started on medical treatment and scheduled for urgent tenopla…

Conjunctival Melanoma A 55-year-old male who presented to Bascom Palmer for a multi-year history of a progressively enlarging painless pigmented conjunctival lesion of the right eye. He was found to have a large non-mobile pigmented lesion of the right perilimbal conjunctiva. While initially he was…

Nontuberculous Mycobacterium Keratitis A 39-year-old Hispanic male presented to the Emergency Room with worsening blurry vision and pain in the left eye for 1 month after feeling something “fly into his eye” while cutting wood. Visual acuity was 20/40 on presentation with a small 1 x 1 mm multi…

Silent Brain Syndrome A 34-year-old male presents for corneal evaluation with progressive decline in vision in both eyes associated with pain, redness and discharge. The patient’s past medical history is notable for a cerebellar cyst that was removed at age 21 and placement of a ventricular-atria…

Bilateral Limbal Stem Cell Deficiency A 32-year-old female patient with bilateral chemical ocular burn. On ocular examination revealed 20/300 and 20.400 vision, with bilateral limbal ischemia and corneal epithelial defect, treated with saline solution irrigation and multiple amniotic membranes. Pat…