A 53-Year-Old Woman With 'Spots on Her Eyes'

Melissa Vitek, OD; Case Series Editor: Jean Marie Pagani, OD


September 18, 2013

Clinical Presentation

A 53-year-old Asian woman presented for an eye examination. She had not had an eye examination in 35 years. She reported seeing "spots on the front of her eyes" for several years. She did not think that the spots had changed in appearance over the years. She had no visual complaints aside from having some difficulty reading without her glasses, which were +2.00D over-the-counter readers.

The patient denied a history of strabismus, ocular surgery, or trauma, and stated that she had never worn prescription spectacles or contact lenses. She stated that she is in good health but has never seen a primary care physician. She reported taking no medications and denied allergies to medications or seasonal allergies.

Best-corrected visual acuity was 20/25+1 OD and 20/25+2 OS at distance and 20/25 in both eyes at near. Slit lamp examination revealed that the corneal epithelium was intact in both eyes, with no evidence of sodium fluorescein staining. The corneal endothelium appeared normal in both eyes. Central corneal thickness was measured at 535 microns OD and 530 microns OS. The anterior chamber was clear with no cell or flare, and the estimate of the anterior chamber using the Van Herick technique was grade 2 OU (Figures 1, 2). All other findings of the patient's ocular health evaluation were normal.

Figure 1. Photograph of the anterior segment of the right eye.

Figure 2. Photograph of the anterior segment of the left eye.