MAKE UP UNDER THE EYELID

BITOT'S SPOT

A Bitot's Spot is an area on the white part of the eye that doesn't wet well and appears keratinized.  It is often associated with vitamin A deficiency.  It is fairly asymptomatic and patients are unaware they have it when it is discovered. Vitamin A deficiency happens mostly in children in developing countries, but we often see it in college kids for various reasons (including malnutrition and alcohol consumption).   Bitot's Spot is often one of the first signs of Vitamin A deficiency.  Advanced deficiency can lead to night blindness. 

VITREOUS FLOATER

Our eyes are fluid-filled and you can often see floaters.  The arrow points to a floater in this patient's eyes and the dark spot behind it is the shadow of the floater on the retina. 

CORNEAL TRANSPLANT

This is what a cornea looks like after a cornea transplant.  Best visual acuity is usually around 20/50 after a transplant with a significant amount of astigmatism.  Transplants can become necessary if the cornea is scarred, or is shaped incorrectly, or has opacities or irregularities from genetic corneal diseases.

GLAUCOMA

One of the things we look at when we dilate the eye is the optic nerve cupping.  It's the white area in the middle of the optic nerve in the photo below.  The smaller the white area the less the risk for glaucoma.  As pressure damages the optic nerve, the white area grows and your peripheral vision decreases until you're blind.  The 2nd photo shows an eye with glaucoma.  Note the absence of pink area inferiorly.  

CATARACT

The top photo shows a lens with no cataract and the bottom shows one with a thick nuclear cataract. 

COLD SORE ON THE EYE!

Herpes Simplex Virus resides in the nerve centers of about 95% of the population.  It is responsible for cold sores on the lips.  When it activates in the eye, it can cause discomfort, decreased vision, pain, light sensitivity, and watering.  HSV can reactivate during periods of stress or with extreme exposure to sunlight. 

When HSV activates on the eye, we treat it with antivirals and watch very carefully for scarring and secondary inflammatory damage.  It can be very serious and even cause blindness if mismanaged.