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 Table of Contents  
Year : 2021  |  Volume : 59  |  Issue : 4  |  Page : 418-419

Photo quiz

Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Puducherry, India

Date of Submission29-Apr-2021
Date of Acceptance06-Dec-2021
Date of Web Publication21-Dec-2021

Correspondence Address:
Dr. Josephine S Christy
Aravind Eye Hospital, Cuddalore Main Road, Thavalakuppam, Puducherry - 605 007
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_52_21

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How to cite this article:
Christy JS, Nagtode AH. Photo quiz. TNOA J Ophthalmic Sci Res 2021;59:418-9

How to cite this URL:
Christy JS, Nagtode AH. Photo quiz. TNOA J Ophthalmic Sci Res [serial online] 2021 [cited 2022 Dec 10];59:418-9. Available from: https://www.tnoajosr.com/text.asp?2021/59/4/418/333174

  Questions Top

  1. Identify the condition and its recommended gold standard treatment. What is the rising alternative treatment modality for this condition? What is the recent noninvasive method used for the diagnosis? [Figure 1]
  2. Identify the following condition and name the condition which can result in this complication.

  3. What is its first line of treatment? [Figure 2]

  4. Identify this classical finding and the causative organism.

  5. While fluorescein stains the bed of the ulcer, which stain identifies the bulb margins clearly?

    What are the diagnostic tests available to confirm HSV other than the straightforward clinical diagnosis? [Figure 3]

  6. Which layer of graft rejection leads to the following presentation? Name it.

  7. What is the difference between graft rejection and graft failure? [Figure 4]

  8. Identify the following condition. What is the classical pattern seen in corneal topography. How is it different from keratoconus and Terrien's marginal degeneration? [Figure 5]
Figure 1: Ocular surface squamous neoplasia

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Figure 2: Shield ulcer

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Figure 3: HSV

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Figure 4: Khodadoust

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Figure 5: Pellucid marginal degeneration

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  Answers Top

  1. Ocular surface squamous neoplasia (OSSN), surgical excision with 2 − 4 mm clearance margin

  2. Topical chemotherapy with Mitomycin-C (0.02%–0.04%) or interferon alpha-2b (1 million IU/ml).

    High-resolution/ultrahigh-resolution spectral domain optical coherence tomography

  3. Shield ulcer, vernal keratoconjunctivitis/spring catarrh

  4. Topical corticosteroids along with tear substitutes and topical antibiotics.

  5. Dendritic corneal ulcer, herpes simplex virus. rose bengal stain.

    1. Giemsa stain for multinucleated giant cells
    2. Immunofluorescence assay for HSV-1 antigen
    3. Polymerase chain reaction for HSV-1 DNA.

  6. Khodadoust line and endothelial rejection

  7. Corneal graft rejection is a reversible immune response against donor antigens. If signs of immunologic graft rejection do not clear within 2 months of adequate treatment, the diagnosis of graft failure is made. Graft failure is the irreversible loss of graft clarity.

  8. Pellucid marginal degeneration (PMD), beer belly/crab claw pattern. PMD has inferior thinning of the cornea typically from 4 to 8'o clock. It progresses throughout patient's life time unlike keratoconus. Keratoconus has central or paracentral thinning of the cornea and Terriens Marginal degeneration causes superior thinning of the cornea associated with neovascularization and lipid deposition.

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Conflicts of interest

There are no conflicts of interest.


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]


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