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Photos taken by: Rona Lyn Esquejo-Leon, CRA.
Used with permission. Not to be reproduced.

Corneal images are from a 63-year-old Caucasian female who complains of poor near vision in each eye and a graying in her left visual field. The top row of pictures is of the right eye, and the bottom row of the left eye. In June 2008 an I-125 radioactive plaque was placed on the sclera of the left eye to treat a choroidal melanoma. The patient has insulin-dependent diabetes mellitus without diabetic retinopathy. There is no family history of ocular disease. Ophthalmic examination showed a best-corrected visual acuity of 20/20 in the right eye and 20/40 in the left eye. Positive findings are the bilateral corneal changes seen in the images, moderate nuclear sclerotic cataracts, and an elevated, pigmented, choroidal lesion with surrounding radiation retinopathy located superotemporally in the left eye.

1.	The locations of the corneal opacities are:
	a. epithelium b. endothelium c. anterior stroma d. posterior stroma e. central 2/3 of cornea f. (d) and (e)
2.	The opacities are described as:
	a. grayish white b. infiltrates c. edema d. polygonal patches separated by relative clear zones e. deposits f. (a) and (d)
3.	These corneal opacities would be expected to cause these symptoms:
	a. decreased vision b. photophobia c. foreign body sensation d. redness e. no symptoms
4.	The dignosis is:
	a. polymorphic amyloid degeneration b. Fuchs' dystrophy c. macular dystrophy d. posterior crocodile shagreen e. disciform keratitis

For answers to the above, click here on or after April 12, 2011.