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JAMA Ophthalmology Clinical Challenge
April 4, 2019

An Unusual Corneal Mass

Author Affiliations
  • 1Duke Eye Center, Durham, North Carolina
JAMA Ophthalmol. 2019;137(6):716-717. doi:10.1001/jamaophthalmol.2019.0519

A 74-year-old man was referred to the ocular oncology clinic for a right eye corneal mass. He had a history of herpetic keratitis and cataract surgery 2 years prior, both in the right eye, complicated by postoperative bullous keratopathy without treatment. The patient noted a corneal scar after the cataract surgery that gradually thickened over the ensuing 6 months. In our office, his examination in the right eye was notable for hand motion visual acuity and a pearly white, raised, 10 × 10-mm, gelatinous, corneal lesion with both intrinsic and feeder vessels (Figure 1A). There was no view of the anterior segment. Ultrasound biomicroscopy showed a hyperechoic opacity on the surface of the cornea, with maximal thickness of 1.5 mm. A cleft was noted between the lesion and the cornea (Figure 1B). There was no extension posteriorly into the anterior chamber, iris, or ciliary body.