This particular photo comes from Ms. VM, an 86 y/o white female who presented with complaints of reduced vision in both eyes. She also mentioned that her left eye (the eye pcitured) was red, sore, and aching with a foreign body sensation over the last week.

She had a heart condition and arthritis. Her meds included Cardizem, Dyazide, Motrin, and baby Aspirin.

No significant family history of any significant eye or systemic disease.

Refraction showed best corrected vision of about 20/50 in the right and the left.

Biomicroscopy showed significant cataracts in both eyes, open chamber angles, and completely normal anterior segment health in the right eye (other than the cataract).

The left eye however, showed up with the raised area seen in the photo. She did not recall ever noticing it.

Retinal health was normal in both eyes.

IOP at the time of examination was 17 OD and 20 OS.

Soooo... what's up with this lady? What should your differential diagnosis include? What should you do with her?

Please take the time to participate. The more that join in, the better the experience will be for all.

Thanks!

Walt Mayo, OD