A 48-Year-Old Man With Tearing and Photophobia

Alissa M. Coyne, OD; Case Series Editor: Jean Marie Pagani, OD


July 25, 2013

Clinical Presentation

A 48-year-old black man presented to the emergency department with a chief complaint of discomfort in the left eye with tearing and light sensitivity for the past 5 days. Ocular history included a minor injury as a child with unknown location, but no long-standing visual or ocular problems were reported. His systemic history was unremarkable.

Examination findings included the following:

  • Best-corrected visual acuity: 20/20 OD, 20/25 OS

  • Pupils and extraocular motilities: normal

  • Confrontation visual fields: full to careful finger count

  • Slit-lamp examination: normal, OD; central corneal lesion, OS (Figures 1 and 2); no anterior chamber reaction observed, OU

  • Goldmann tonometry: 12 mm Hg OU

The dilated fundus examination revealed no vitreal abnormalities; 0.2 cup-to-disc ratios with healthy neuroretinal rims; and clear maculae and peripheral eye grounds, OU.

Figure 1. Lesion under white light with sodium fluorescein staining.

Figure 2. Lesion showing hyperfluorescence under cobalt blue light.


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