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JAMA Ophthalmology Clinical Challenge
May 2018

Bilateral Corneal Deposits 1 Week After Starting Oral Prednisone Therapy

Author Affiliations
  • 1Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
  • 2Department of Pathology, Mayo Clinic, Rochester, Minnesota
JAMA Ophthalmol. 2018;136(5):591-592. doi:10.1001/jamaophthalmol.2017.5316

A man in his 30s presented with bilateral blurry vision a week after starting prednisone therapy for a presumed seronegative spondyloarthropathy. He had no other pertinent medical history and no relevant ocular history other than anisometropia, for which he wears a corrective contact lens in his right eye. At his initial ophthalmology visit, his best-corrected visual acuity was 20/40 OD and 20/20 OS. In both corneas, he had numerous multicolored, highly refractile crystals located primarily in the subepithelium and anterior stroma (Figure 1). No deposits were noted in the retina of either eye on funduscopic examination.

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