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JAMA Ophthalmology Clinical Challenge
March 11, 2021

Bilateral Asymmetrical Corneal Deposits in an Asymptomatic Patient

Author Affiliations
  • 1Department of Ophthalmology, Dean McGee Eye Institute/University of Oklahoma, Oklahoma City
JAMA Ophthalmol. Published online March 11, 2021. doi:10.1001/jamaophthalmol.2020.4656

A 70-year-old White woman with a history of hypertension and hyperlipidemia was referred to our institution for evaluation of bilateral asymmetric corneal lesions by her primary eye care professional. The patient required spectacles for best-corrected visual acuity but otherwise had no other significant ocular complaints. She was not taking medications known to cause corneal depositions, nor was there a known family history of corneal dystrophy. Best-corrected visual acuity was 20/20 OU. Slitlamp examination of the cornea of the right eye revealed multiple, discrete nodular opacities in the superior and inferior quadrants without neovascularization or surface elevation. Similar findings were seen in the left eye, but the superior lesions were notable for possessing well-circumscribed, plaquelike features located in the posterior stroma without involvement of the anterior surface (Figure, A). No crystalline changes were noted with these deposits.

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