Corneal Opacity case

Presented by Dr Ankit Gupta at JNMC, WARDHA.

1. CASE PRESENTATION Moderator- Dr Archana Ma’am Conductor- Dr Kanchan Ma’am Presenter- Dr Ankit

2. 61 year old male, Hindu by religion, Farmer by occupation, Resident of Antora , Wardha. Came to eye OPD with Chief complaints of: Diminution of vision in left eye since 1 year.

3. HISTORY OF PRESENT ILLNESS Patient was apparently alright 1 year back when he started noticing diminution of vision in left eye which was Insidious in onset Gradually Progressive in nature Not associated with pain

4. NEGATIVE HISTORY No h/o any use of topical drugs in the eye No h/o discharge No h/o Malaria, HS keratitis.

5. Past medical history: No h/o hypertension and diabetes mellitus. Past ophthalmic history: Patient gives a history of trauma to both eyes 10 years back by falling on gravel . After which he had redness, watering and pain in both eyes and developed whitish opacity in a month . He had not taken any treatment for the same.

6. Personal history: Not significant Family history: Not significant

7. GENERAL EXAMINATION Conscious, cooperative & well oriented to time, place and person Average built Afebrile Pulse -70 beats/min Blood pressure- 110/80 mm of Hg No pallor, icterus, cyanosis, clubbing, lymphadenopathy and oedema feet

8. SYSTEMIC EXAMINATION Cardiovascular system : WNL Respiratory system : WNL Per-abdomen : WNL Central nervous system : WNL

9. Right eye Left eye Vision Distance With pinhole 6/60 No Improvement 6/36 No Improvement Eyelids Position Movement Lid margin Eye lashes NORMAL NORMAL Conjunctiva Bulbar Palpebral Limbal NORMAL NORMAL Ocular examination : Head posture – straight Forehead - senile wrinkles Eyebrows - normal

10. Right eye Left eye Cornea Size Shape Surface Transparency Sensations Vascularisation Could not be assessed Could not be assessed Smooth Maculo-leucomatous opacity from 3-9 o clock Absent Present Normal Normal Smooth Adherent leucoma at 3 o clock Present Present

11. Right eye Left eye Anterior chamber Depth Contents Deep No abnormal contents Irregular No abnormal contents Iris Colour Pattern Normal Normal Normal Normal Pupil Number Size Shape Position Pupillary margin Pupillary reflex Single 4-5 mm Vertically oval Central Normal Shimmering Single 3-4 mm Normal Central Normal Greyish white

12. Right eye Left eye Pupillary reaction Direct Consensual Could not be elicited Normal Could not be elicited Lens Position Shape Color Normal Normal Glassy (PC IOL) Normal Normal Greyish white Intraocular pressure (NCT) 13 mm of Hg 16 mm of Hg Lacrimal apparatus Punta Sac area Regurgitation test Syringing Normal Normal Negative Patent Normal Normal Negative Patent Ocular movements Uniocular Binocular Free and Full in all directions of gaze Free and Full in all directions of gaze

13. SLIT LAMP EXAMINATION Right Eye: Maculo-leucomatous opacity from 3 to 9 o clock Corneal thinning inferiorly Corneal vascularization (superficial) Conjunctivalization of cornea 360 degree Vertically oval pupil Deep AC

14. RIGHT EYE

15. Left eye Corneal degeneration Adherent leucoma at 3 o’clock with vascularization (superficial) Nebulo macular opacity from 10 to 2 o’clock para centrally Irregular AC

16. LEFT EYE

17. PROVISIONAL DIAGNOSIS Right eye- Maculo-leucomatous opacity from 3-9 o clock with Pseudophakia Left eye- Adherent leucoma at 3 o clock with Immature senile cataract

18. THANK YOU ! NEXT PG ACTIVITY: 11/10/2021 CASE PRESENTATION ON RETINAL VEIN OCCLUSION PRESENTER: DR ABHISHEK MODERATOR: DR SUNE SIR CONDUCTOR: DR PRANAY SIR