Fig. 3.1
(a) A larger lesion (arrow) containing many rounded bodies (arrowhead) and a small adjacent one (double arrowhead). (b) Some parts of the lesion (bowed arrow), the adjacent one (double arrowhead) and some or the rounded bodies (arrowhead) are protruding (dark) in the green stained tear film (The arrowheads and the straight arrows are placed in corresponding locations)
Fig. 3.2
(a) Smaller and larger lesions in apposition; visible are rounded bodies (arrowhead) and confluent structures (bowed arrow) with no discernible details. (b) The abnormal structures (bowed arrow) are light-reflecting (greyish) and protruding (dark) in the tear film stained green with fluorescein. (The arrows are placed in corresponding locations. (a) is a composed photograph.) (see also Figs. 1.1 and 2.17)
Fig. 3.3
(a–c) At various occasions, the epithelium showed rounded bodies (white arrowheads), cysts (black arrowheads), some (b) staining green with fluorescein and some (c) containing rounded bodies (double arrowhead); (c) additionally shows epithelial lines (arrow; cf. Fig. 1.24). (d) Infiltrate captured after 10 days of cortisone treatment; its lobulated shape implies confluence of 2, possibly 3 rounded infiltrates in apposition (cf. Cases 2 and 3)
Case 2. Stromal Infiltrates During the First Episode of Recurrent Erosion
Case Report
A 40-year-old man presented with pain in the left eye struck by a leaf 2 days previously. The paracentral lower cornea showed an epithelial erosion that healed with antibiotic ointment. Three months later, the cornea suffered a new, spontaneous erosion in the same location. The right cornea appeared normal. Within 2 days of treatment with chloramphenicol ointment developed two subepithelial infiltrates in the paracentral lower cornea. After a further 2 days with neomycin-bacitracin ointment, the infiltrates appeared unchanged, but they started to resolve with addition of prednisolone acetate drops 0.5 % twice a day. Conjunctival smears revealed Staphylococcus aureus sensitive to the used antibiotics.
The patient had chronic blepharitis, bouts of urticaria and a family history of allergy.
The photographic series starts on day 1 (after 3 days of cortisone treatment) and follows the resolution of the infiltrates captured on days 3, 8 and 15 and after 6 weeks.
Fig. 3.4
(a) Two infiltrates (arrows) in apposition. (b) shows the light-reflecting property of the left infiltrate; the arrow indicates its rounded centre which in (c, arrow) appears darker than its surroundings. (The arrows in b and c are placed in corresponding locations)
Fig. 3.5
Upper row: Survey; the image to the right shows fluorescein staining in the centre of the left infiltrate and in the lower part of the right one (blue filter). Lower row: The left infiltrate starts to clear in the rounded central area (arrows, placed in corresponding locations)
Fig. 3.6
Upper row: Survey; the image to the right shows no fluorescein staining of the left infiltrate; a small area stains in the right one (blue filter). Lower row: ongoing clearing of the rounded central area (arrows, placed in corresponding locations)
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