Black dot

Posted by - Posted on 07/29/2015 02:04:09 Glaucoma


60 year old with history of glaucoma presented to the clinic for the first time. On your exam you see what was shown in the picture. What does it tell you? If this patient were to be apahkic, what potential complication can you anticipate?

Diagnosis:  Adrenechrome deposits 

Reason:  These are oxidized metabolites of topical epinephrine drops that can be seen in the conjunctiva, cornea and lacrimal system. 

The presence of these deposits indicate that this patient was on lonterm epinehrine in the past. 

Topical Epinephrine in Aphakia:  can cause CME 

Other fun facts about topical epinephrine

Both alpha and beta agonist

Variable IOP reduction

Pupillarty dilation and hence should be avoided in patients with narrow angles

Hypertension, arrhythmia

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