- A 40-year-old male farmer presented with a 15-year history of vision loss in his right eye. - He had injured his right eye during paddy harvesting which led to pain, redness, and watering. His vision gradually worsened until he had no vision in that eye. - Examination of the right eye revealed a bluish white corneal opacity covering the entire cornea with outpouching. The anterior chamber could not be seen. - Differential diagnoses included anterior staphyloma, corneal ulcer with ectasia, and chemical burn. The provisional diagnosis was anterior staphyloma with corneal opacity and nystagmus.

1. CLINICAL
CASE
PRESENTATION
By: Dr. Srijit Mohanty

2. Patient Particulars
Name : Sitaram Oram
Age : 40 years
Sex : Male
Religion : Hindu
Address : Aithapalli, Jharsuguda
Occupation : Farmer
Chief Complaints
• Loss of vision in Right Eye since 15 years

3. History of Present Illness
Patient presented to the Out Patient Dept with history of
• Injury to the R.E. during paddy harvest
• Following which there was pain and redness in R.E.
• After some days the sensation of itching developed in R.E.
• There was also increased watering in the same eye.
• The patient had consulted an Ophthalmologist but there was no
change in the condition of the eye.
• There was gradual loss of vision in R.E. which resulted in no
vision in R.E.

4. History of Past Illness
• Patient did not have any similar illness
• Patient does not suffer from any chronic illness such as
Hypertension, T2 Diabetes Mellitus, etc.
• There is no history of application of medicine

5. Personal History
Family History
• No significant history
• No significant history

6. Examination
General Examination
 Patient is conscious, cooperative and well oriented to time, place
and person.
 Temp: Afebrile to touch
 Pulse: 70 b/min
 Blood Pressure: 110/70 mmHg
CVS: Normal S1 and S2 heard
Respiratory: Normal vesicular sounds heard
CNS: Higher mental functions intact

7. Examination
Position of Head: Erect
Face: Facial symmetry is maintained
Ocular Examination
Right Eye Left Eye
1. Orbital Margin No abnormality No abnormality
2. Eye Lids Normal, no swelling or
deformities seen
Normal, no swelling or
deformities seen
3. Palpebral aperture Normal Normal
4. Lacrimal apparatus No abnormality seen No abnormality seen

8. Right Eye Left Eye
5. Eye position In exotropia No abnormality seen
6. Eye movement Irregular horizontal
twitching seen
Normal movement in all
directions seen
7. Eye size Normal Normal
8. Conjunctiva No abnormality seen No abnormality seen
9. Sclera Appears white, no
abnormality seen
Appears white, no
abnormality seen
10. Cornea A bluish white opacity with
outpouching, covering the
entire cornea
Clear,
Ocular Examination

10. Right Eye Left Eye
11. Anterior chamber Could not be seen No abnormality seen
12. Iris Could not be seen Black, no abnormality
seen
13. Pupil Could not be seen Round, Regular, Reactive
Internal Examination
Opthalmoscopy Not done Not done
Functional Examination
Visual Acuity (distant) No Light Perception 6/6
Ocular Examination

12. Differential Diagnosis
1. Anterior Staphyloma

13. Differential Diagnosis
2. Corneal ulcer with ectasia

14. Differential Diagnosis
3. Fuchs’ endothelial dystrophy
• Bilateral
• More commonly occurs
in women

15. Differential Diagnosis
4. Peters Anomaly
• usually bilateral
• occurs due to developmental
disorder

16. Differential Diagnosis
5. Chemical Burn

17. Provisional Diagnosis
Anterior Staphyloma with corneal opacity and Nystagmus

18. Thank You