CORNEA EPITHELIAL EDEMA IN IRIDOCORNEAL ENDOTHELIAL SYNDROME (ICE)

FLOATERS CAUGHT RED-HANDED

PALPEBRAL CONJUNCTIVAL FOREIGN BODY

A gentleman presented with extreme pain in his left eye.  It occurred while he was cutting prickly pear cactus and hour earlier. Slit lamp exam exam with fluorescein dye revealed the following. 

Vertical lines on the cornea indicate a foreign body on the palpebral conjunctiva under the upper eyelid.  

Lid eversion revealed an embedded cactus spine. 

Without the dye it is much more difficult to see the cactus spine. 

The spine was removed with a jewelers forceps. 

Further investigation revealed another spine in the eyelid near the meibomian gland openings.  No further spines were found on more extensive investigation. 

PSEUDOEXFOLIATION

TRIPLE CATARACT

This patient has an anterior capsular, nuclear, and posterior subcapsular cataract.