This pt. came to me for urinary problem. When I examined his eye & enquired , he said since 2 yrs he is seeing somewhat less with his eye. on asking how it started, he could not pinpoint something specific as he is chronic schizophrenic. What is the diagnosis? What is DD ? treatment ?

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Fleshy pterygium with corneal opacity at the apex. Lower lid skin pigmentation seems due to contact dermatitis. Pterygium excision with conjunctival autograft is needed. For lids dermatitis antibiotic steroid ointment should be used. Diminished vision seems to be due to central corneal affection and Refractive Errors caused by pulling by pterygium.

It's pterygium as Dr Basant mentioned
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Luecoma - carnea Sequele of Trauma. Keratitis. Carneal ulcer-healed Dermatological- Rosacia. The mention of uti - And link with keratitis is farfetched as NGU is to be proved as well as reactive arthritis is present - to consider Reiter's. If the opacty is since child hood and other stigmata r present u can think of interstitial keraritis of cong. Syphilis. All these r just for discussion sake. The r not intended diagnosi. Keratoplasty may be needed. Opthalmologist is the right person to be quizzed, not dermatologist.

Looks like corneal opacity; rule out any h/o trauma or viral exanthem in childhood! Check for visual potential, assess the fundus and then we can decide if this pt can be given somw optical rehab

Concluding the above case ------- Yes , the opacity is due to previous injury to the eye about 2 yrs back. The pt. was hesitant but pt's mother gave the history. Thus the opacity is due to corneal ulcer. Most of you have diagnosed it correctly. However, a few of you have mistaken it for pterigyem. A few points--- Corneal opacity is usually pure white/ just white Pterigyem is not pure / just white. It is rather off white or egg white Opacity can occur at any position on cornea. Pterigyem starts periferally in conjunctiva & progresses slowly to centre of cornea. Pterigyem is generally narrow cone shaped or broad streak shaped with periferal part always broader than centre. Pterigyem mostly occurs in 3 o clock & 9 o clock positions. Opacity can occur at any point. ( Our group's ophthalmologists can correct me if I am wrong) Thanks

Pterygium with corneal opacity . Rx : - try refraction . If vn improves, p rescribe glasses. - follow up every 6 months .

This is pseudo pterygium but not pterygium.Pterygium has an apex, neck and body and if progressive appears vascular.

Chronic Corneal opacity (ulcer ) traumatic origin. Ophthalmologist opinion to r/O any retinal or posterior chamber abnormalities. Treatment. Penetrating Keratoplasty (PK)

Pterygium with corneal opacity at 3__5 o'clock with dilated pupil dilation for most probably for inner exam by Dr Prakash Kulkarni or patient is using some eye drops or alcohol ingestion , diminished vision is due to astigmatism secondary to pterygium and deep seated corneal opacity, refer patient to opthalmologist for further evaluation and treatment

Traumatic cataract

Pterygium

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