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JAMA Ophthalmology Clinical Challenge
July 2018

Blurry Vision and Eye Pain After Pterygium Surgery

Author Affiliations
  • 1Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
  • 2Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia
  • 3Department of Ophthalmology and the Francis I. Proctor Foundation, University of California, San Francisco
JAMA Ophthalmol. 2018;136(7):827-828. doi:10.1001/jamaophthalmol.2017.6054

A woman in her early 70s with hypertension was transferred from an outside hospital with worsening blurry vision, pain, and swelling of the right eye of 10 days’ duration. Her ocular history was significant for pterygium surgery in the right eye 3 years prior, and a review of systems was negative for systemic illness. Visual acuity was hand motions OD and 20/20 OS. Intraocular pressures were 23 mm Hg OD and 16 mm Hg OS. Slitlamp examination of the right eye was notable for nasal scleral necrosis and thinning with adjacent conjunctival injection and chemosis (Figure), mild corneal thinning nasally, shallowness of the anterior chamber and 3+ anterior chamber cell, inferior posterior synechiae, mild nuclear sclerosis of the lens, and no view posteriorly. B-scan ultrasonography revealed a posterior vitreous detachment without vitritis and an attached retina. Examination results from the left eye were unremarkable.

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