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Photo Essay
October 2006

A Transilluminating Scleral Lesion

Arch Ophthalmol. 2006;124(10):1504. doi:10.1001/archopht.124.10.1504

A 63-year-old white woman in good health was referred for evaluation after an optometrist noticed a darkly pigmented scleral lesion in the right eye. Visual acuities were 1/60 OD and 6/9 OS (OD+1.25DS; OS+2.25/−3.50/020). She was completely asymptomatic. She did not have rheumatoid disease.

Examination revealed exotropia of the right eye along with a smooth, elevated grayish lesion (Figure 1). When the slitlamp was shone through the pupil, the nodule transilluminated (Figure 2). Dilated funduscopy was unremarkable. On direct inquiry, she revealed that she had undergone squint surgery as a child and had been detained in the hospital for a month while undergoing intensive topical antibiotic treatment.

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