October 2015 Online Photo Diagnosis

By Gregory W. DeNaeyer, OD, FAAO

The photo shows the left eye of a 60-year-old patient who had an episode of acute central corneal edema with bullae. She was wearing a scleral lens (manufactured in Boston XO, Bausch + Lomb [B+L]) in her left eye to improve poor vision because of corneal irregularity that resulted from a herpes zoster virus scar. The patient also had a history of iritis OS. Her cornea appeared healthy without signs of guttata. She was currently on Restasis (Allergan) b.i.d. OD and OS, acyclovir 800mg b.i.d. p.o., and artificial tears.

She was advised to discontinue the scleral lens and was referred back to her cornea specialist. The patient was started on Pred Forte (Allergan) 1% q.i.d. OS, Muro 128 (B+L) solution b.i.d., and Muro 128 ointment at night. The edema resolved in three weeks. She is currently tapering the Pred Forte and has not yet resumed wearing her scleral contact lens.