1/5. Conjunctival biopsy of anophthalmic socket in sarcoidosis.A case of sarcoidosis was diagnosed by a random conjunctival biopsy from an anophthalmic socket. A 22-year-old black female patient presented with anterior and posterior uveitis and subconjunctival nodules in the left eye. Her right eye was enucleated due to a penetrating injury 3 years before admission. biopsy of subconjunctival nodules in the left eye failed to demonstrate granulomatous inflammation; however, a random conjunctival biopsy from the normal-appearing anophthalmic socket conjunctiva revealed noncaseating granulomas. Conjunctival biopsy is a safe, cost-effective means of diagnosis in sarcoidosis suspects. To our knowledge, this is the first reported case of sarcoidosis confirmed with random conjunctival biopsy from an anophthalmic socket.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
2/5. Conjunctival aspergilloma with multiple mulberry nodules: a case report.A 30-year-old healthy female presented with a 1-year history of chronic mucous discharge, tearing, and irritation in the left eye. Slit-lamp examination revealed severe papillary and follicular reaction surrounding a movable subconjunctival mass on the left upper tarsal conjunctiva. Incision and curettage were performed to establish the diagnosis. Multiple peculiar black mulberry nodules were obtained. The clumps of septate hyphae seen with periodic acid-Schiff stain were characteristic of fungus ball (aspergilloma). The patient's symptoms improved significantly after surgery without any antifungal therapy. Although rarely reported, aspergillus is a common fungus in the conjunctiva that may seed into the subconjunctiva. We present this case to remind ophthalmologists of such a rare cause of recalcitrant conjunctival inflammation in immunocompetent patients.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
3/5. Mascara pigmentation of the bulbar conjunctiva associated with rigid gas permeable lens wear.We present three patients who were found to have unusual pigmentation of the bulbar conjunctiva. The areas, 1 to 2 mm in size, were translucent with dark black dust-like particles randomly placed within well defined borders. These specks were usually elevated, had a granular texture, and appeared to be overlying pingueculae. All three patients wore rigid gas permeable contact lenses, were found to have either a short tear break-up time or deficient tear aqueous layer, had associated 3:00 and 9:00 o'clock staining, and routinely used heavy mascara and/or eyeliner. In one patient, the areas resolved on discontinuing contact lens wear. The elevated areas may be associated with minor discomfort. We propose that a deficient tear layer and drying adjacent to the lens edge may compromise the conjunctival epithelium and prevent efficient washing of the pigment particles from the conjunctiva, allowing these granules to become embedded in the epithelium. Additional causes of conjunctival pigmentation are discussed.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
4/5. Cotton-wool spots as a sign in leptospirosis (Weil's disease).A 44-year-old black male presented with fever, myalgia and weakness. He had elevated blood urea nitrogen, creatine phosphokinase and serum glutamic-oxaloacetic transaminase. During the first 6 days of this undiagnosed illness azotemia increased, a pericardial friction rub occurred, and hematuria was present. On the 7th day bilateral subconjunctival hemorrhages, anterior uveitis, and peripapillary cotton-wool spots were noted. This combination of findings suggested leptospirosis, which was subsequently confirmed by specific antibody titers. Therapeutic response was achieved with high-dose systemic steroids.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
5/5. Conjunctival pigmentation associated with tetracycline medication.A 26-year-old man had been treated for acne vulgaris with tetracycline and minocycline orally for 12 years. He developed dark brown to black pigmentary deposits in the palpebral conjunctiva bilaterally. These deposits resembled those seen in epinephrine pigmentation of the conjunctiva. Histologically the pigmented deposits were concretions in conjunctival cysts. Although they contained calcium, the concretions displayed the characteristic yellow autofluorescence of tetracycline under ultraviolet light. Presumably, tetracycline had formed extracellular chelation complexes with calcium, thus accounting for the pigmentation of the conjunctiva.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |