A Case Report of Misdiagnosed Case of Corneal Opacity
- Nitin Mehrotra , Associate Professor, Dept. Of Ophthalmology, GMC, Haldwani, Nainital, Uttarakhand
- Dr Poonam , Post Graduate Junior Resident (3rd year), Dept. Of Ophthalmology, GMC, Haldwani, Nainital. Uttarakhand
- G S Titiyal , Professor and HOD, Deptt. Of Ophthalmology, GMC, HALDWANI, NAINITAL, Uttarakhand
Article Information:
Abstract:
Background: Corneal opacities can be because of multiple causes like trauma,resolved infective ulcer, congenital cause etc. We are reporting this case because of its unusual presentation, Unique yet simple management.s.
Keywords:
Article :
Case Presentation::
A 57 Y/M presented to our opd with chief complaintof diminution of vision Right Eye for last 1 year. He visited eye opd for a second opinion as he was advised for optical penetrating keratoplasty. No history of trauma,redness,previous eye surgery.
On examination vision of pt was Perception of light was present, projection of rays accurate , Adnexa were within normal limit, conjuctiva was transparent,leucomatous grade corneal opacity was present, No vascularisation was present over conea.Iris was only visible peripherally.pupil,lens and rest posterior segments details were not visible.RE was in exotropia of 45 degree ,no vascularization.
Left eye was normal.
Such unusual history force us to perform ant segment OCT. To our surprise it was completely a separate layer from cornea
OCT anterior segment showing separate tissue growth
Address for CorrespondenceDr Poonam, Post Graduate Junior Resident (3rd year), Dept. Of Ophthalmology, GMC, Haldwani, Nainital, Uttarakhand.
DOI: 10.5455/im.258745
This is an Open Access article under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/)
Pachymetry of RE
We planned for alcohol assisted dissection of the growth and sent it for histopathological examination.
BIOPSY SLIDE-Suggestive of epithelial hyperplastic cells
POST OP DAY 1 OF ALCOHOL ASSISTED DISSECTION
POST OP OCT OF RE WITH BCL IN SITU
On Post operative day 1 there was congestion of conjuctiva, cornea of the patient was clear.Aided vision revert back to 6/36 in right eye. On subsequent follow up eye becomes quiet.
Discussion:
Corneal opacity is one of the major cause of blindness.Corneal opacities may be secondary to a wide array of etiologies, including trauma, infection, or inflammation. They may also result from drug deposition, metabolic disorders, and corneal dystrophies or degenerations. It is important in such rare presentations to take an accurate history and to arrange appropriate investigations.
Apart from typical presentation of corneal opacity some unusual cases can be encounterd by the ophthalmologist which need through examination.
Reaching to correct diagnosis solves half of the problem. Proper history, clinical examination and investigation can prevent misdiagnosis of cases.
Conclusion:
This was a rare case of coneal opacity which was misdiagnosed and advised wrongly for penetrating keratoplasty. So for every coneal opacity case before moving to a surgical procedure it is advisable to go for anterior segment oct. It will lead to correct diagnosis and apropriate management.
Financial support
None
Conflict of interest
None
References:
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