Age:

ปีเดือน

sex:


symtom:


history:

A 64-year old Thai woman with irritating symptom OD for one month

She suffered from irritation & tearing in her right eye for one month. Neither redness or discharge found.

Underlying disease
1. Chronic hepatitis B : loss F/U for 1 year
2. DM type 2 : well controlled, diagnosis at 2 months ago
3. Rheumatoid arthritis with history of chloroquine-induced maculopathy 20 years ago

PE:
















OD


OS

VA

6/18 c ph 6/9


6/9 c ph same

IOP

10 mmHg


11 mmHg


Anterior segment Anterior segment of both eyes


Right eye


What should be exam further?


Right upper fornix


Right lower fornix


What is the differential diagnosis? What should  be done?


Do you see something abnormal in this picture?



Note the slit-like lower punctum. This patient undergone multiple DCR and punctoplasty procedures 20 years ago.


diag_link:

Conjunctival mass biopsy was done to exclude lymphoma/other malignancy.

detail:


diff_dx:

Conjunctival mass : lymphoid reaction 1. Non-infectious cause Benign : lymphoid hyperplasia Malignancy : lymphoma 2. Infectious cause TB conjunctivitis Conjunctival papilloma

date_post:

2010-01-14

user_post:

patchara