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Chief complaint
Mr. PG (a 35-year-old male) had been experiencing blurred vision for the past 3 months. He decided that he needed a new spectacle prescription.
History
Past ocular history: He reported an eye injury (OS) while mowing the lawn 4 months ago. He had been struck in the eye with a tree branch. He experienced mild pain and redness for only 2 days. He received no treatment.
Past medical history: Unremarkable.
Exam
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OD |
OS |
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Best corrected visual acuity: |
20/20 |
20/40, no improvement with pinhole |
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External: |
white and quiet |
white and quiet |
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Slit lamp: |
within normal limits |
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dense scar on epithelium in circular shape, not inflamed, well defined, endothelium OK, no staining
[view video] |
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IOPs (applanation tonometry): |
12mmHg |
11mmHg |
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Keratometry (Ks): |
no distortion |
no distortion |
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Pachymetry: |
555 |
500 (interesting that OS is thinner) |
Assessment
Corneal scarring OS with decreased visual acuity (odd corneal lesion case--etiology)
Plan/Treatment
- Referred to corneal subspecialist
- Consultation: S/P corneal trauma from tree branch with secondary toxic reaction and scarring?
- Course of Pred Forte q4h for 3 weeks. Slight reduction in hazing and 2-line improvement in visual acuity while on steroid.
Go to: Anterior segment grand rounds CE table of contents
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