23 year old female with 3 weeks h/o red eye

Posted by - Posted on 09/26/2016 10:36:11 Cornea and External diseases


23 year old female from india with 3 weeks h/o red right eye.. Exam picture attached.

What is the pathophysiology of this condition?

What is the presumed etiology of teh underlying condition?

What is the presumed etiology of the redness and inflammation?

How would you manage this patient?

Leave a Comment:

Nishika Muddasani 10/09/2016 13:37:18

I agree with the broad differential that Sara stated. It looks like pingueculitis based on this image. The patient isn't risk of pinguecula based on her geographic location (increase UV light and dry air). Most pinguecula occur on the nasal side; it has been hypothesized that light going to the temporal cornea is partially blocked by the nose unlike light hitting the medial cornea. Lubrication and topical steroids for now. If the patient does develop recurrent issues with this you can excise it or laser photocoagulate which has a similar cosmetic outcome.

Sara Dela Rosa 10/08/2016 02:49:26

Differential for this lesion can include pinguela/pingueculitis (usually caused by sunlight, wind, UV exposure), papilloma (in young people HSV, older people UV), lipoma or dermolipoma, granuloma (can be associated with multiple systemic conditions), CIN. The picture and vignette to me seem more consistent with inflamed pinguecula. The irritation can be caused by environmental exposure (dust, sunlight, wind, etc). If the pinguecula becomes sufficiently inflamed/enlarged it can also prevent adequate lid closure which can further irritate the eye and cause exposure keratopathy. I think Audra's approach with lubrication and topical steroid would be appropriate. However, if this problem becomes recurrent, excision should be considered.

Audra Zimmer 10/07/2016 22:38:02

1. Breakdown of the elastic tissue of the conjunctiva. 2. May be from UV damage 3. Her lesion looks raised enough to cause irritation. 4. I would try lubrication and a course of topical steroids first

Daniel Salisbury 10/05/2016 20:51:52

1. Overgrowth of vascular tissue due to chronic irritation 2. Presumed etiology of the underlying condition would be chalazion or some other upper eyelid abnormality 3. Redness and inflammation is likely 2/2 vascular growth from irritation from overlying chalazion. 4. Treat the underlying condition (i.e. chalazion or other overlying irritant) and monitoring for resolution of pyogenic granuloma