August 2024 - 1
Author: Dr Robert McDonald
58-year-old female presents with acute onset of eye pain and mild redness.
History of uveitis, RD and glaucoma. Pseudophakic OU. Unaided VAR 6/6, VAL 6/24 N5 (monovision correcting to 6/6)
Patient has been having episodes of pain over the past 4 months, mostly affecting the left eye but on one occasion both eyes. Pain mostly present in the mornings, always the day after she has been into the office.
What is the most likely cause of the pain?
A - Recurrent corneal erosion (RCE) syndrome
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B - Chemical injury
CORRECT!
C - Dry eye
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D - Uveitis
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Answer B
The images show a concentration of punctate epithelial erosions (PPEs) in a line along the visual axis, with the superior cornea clear and diffuse PEEs noted inferiorly. Topical anaesthetic completely resolved the pain. The pain started after the patient had a new hairstyle and started using hairspray on days she is attending the office. The diagnosis was confirmed as Epitheliopathy due to mild chemical injury from hairspray.
The patient lubricated the eye for a few days and was recommended to use hair gel or mousse like in the 80s.
