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May 2016

A Postmortem Ocular Finding of Tache Noire in a Living Patient

Author Affiliations
  • 1College of Physicians and Surgeons, Columbia University, New York, New York
  • 2Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University, New York, New York
  • 3Office of Chief Medical Examiner, New York, New York
JAMA Ophthalmol. 2016;134(5):603-604. doi:10.1001/jamaophthalmol.2015.5951

Patients in the intensive care unit develop exposure keratopathy in the setting of sedation and severe illness. This chronic drying of the ocular surface can cause corneal ulceration and even perforation.1 In a patient who was being treated in the intensive care unit, desiccation in the exposed part of the eye produced a pattern of scleral discoloration known to forensic pathologists as tache noire de la sclerotique, which is an early postmortem darkening of the sclera where the eye is not covered by the lids.2 To our knowledge, this is the first report of a postmortem eye finding in a living patient.

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