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Figure 1

Figure 2

All photos courtesy of: LV Prasad Eye Institute
Used with permission. Not to be reproduced.

A 28-year-old man complained of off-and-on redness, photophobia and burning sensation in the right eye for the past 6 years [Figure 1]. There was a history of frequent usage of medications and photo-therapeutic keratectomy 2 years back, with no significant improvement. Slit lamp examination [Figure 2] revealed temporal conjunctival congestion, with epithelial haze of the cornea. Anterior chamber and fundus examination through the nasal cornea was normal. The left eye was essentially within normal limits.

1.	What could be the most appropriate differential clinical diagnosis?
	a. microbial keratitis b. toxic medicamentosa c. none of the above d. any of the above
2.	Surprisingly, the final diagnosis on this patient was ocular surface squamous neoplasia. What is the best diagnostic tool for this?
	a. corneal scraping b. indirect fluorescent antibody assay (IFA ) c. culture d. impression cytology
3.	The best management is:
	a. excision of corneal and conjunctival component b. (a) + post-op mitomycin-C (MMC) and 3 monthly follow up c. (a) + edge cryo and 3 monthly follow up d. topical MMC

For answers to the above, click here on or after December 23, 2008.