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April 2015

A Case of Bilateral, Multiple, Symmetric, Concentric Ring-Shaped Opacities in the Cornea

Author Affiliations
  • 1Cornea Services, Aravind Eye Hospital, Madurai, India

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Ophthalmol. 2015;133(4):483-484. doi:10.1001/jamaophthalmol.2014.5379

This case report describes a rare and intriguing case of bilateral concentric ring-shaped opacities not associated with any ocular or systemic conditions.

A man in his 70s with no specific ocular symptoms presented for a routine ophthalmic examination. He had no history of eye surgery. Best spectacle-corrected visual acuity was 20/20 OU. Results of slitlamp examination of the right eye showed a normal conjunctiva with healthy ocular adnexa. The cornea showed a normal luster and even surface with no distinct arcus senilis. While the anterior stroma was normal, 4 symmetric concentric ring-shaped opacities were seen in the posterior corneal stroma (Figure, C). All the rings were complete, with the outermost (first) ring located approximately 4 mm from the limbus. From the periphery to the center, the approximate vertical diameters of the 4 rings were 6.0 mm, 4.8 mm, 4.5 mm, and 3.6 mm, respectively (Figure, D and E).

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