Photo Rounds

5 cases, 1 cause of irritated eyes

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Irritated and watery eyes. Mild erythema of the nasal bulbar conjunctiva. Photophobia. Blurred vision. These were just some of the signs and symptoms that prompted the following 5 patients to seek treatment. Though the specifics of their cases varied, their diagnosis was the same.

CASE 1 A 35-year-old man presented with a foreign-body sensation and tearing of his right eye that had lasted for a few days. The eye showed mild erythema of the nasal bulbar conjunctiva and linear corneal abrasions.

CASE 2 A 23-year-old woman came in complaining of an irritated and watery eye that had been bothering her for the past 24 hours. She had normal visual acuity, bulbar conjunctival injection, and linear corneal abrasions.

CASE 3 A 28-year-old man presented with irritation, photophobia, and redness of his left eye that had been bothering him for the last 2 weeks. He had been treated with a topical antibiotic, but showed no improvement.

CASE 4 A 15-year-old girl came in complaining of irritation of the left eye over the last month. She was seen by an ophthalmologist, who attributed her symptoms to exposure keratopathy due to lagophthalmos—inability to close, or poor closure of, the eyelids (FIGURE). He treated her with different lubricants and antibiotics, without improvement.

CASE 5 A 15-year-old boy came in complaining of blurred vision in his right eye. His ophthalmic history was significant for corneal abrasion following a vague history of trauma to that eye a month ago. His best corrected visual acuity in that eye was 20/60.

FIGURE
Eye irritation attributed to exposure keratopathy

An ophthalmologist attributed this 15-year-old’s irritation of the left eye to exposure keratopathy due to lagophthalmos—inability to close, or poor closure of, the eyelids. (The green color is fluorescein dye.) Treatment with various lubricants and antibiotics provided no relief.

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