(PDF 243 KB)
Band Keratopathy in Sarcoid
A 68-year-old male with sarcoidosis complained of progressive ghosting of vision in the right eye. Visual acuity was 20/50 but improved to 20/20 with astigmatic correction. Corneal biomicroscopy revealed peripheral and midperipheral subepithelial opacification in a reverse-C pattern with sparing of the central visual axis. There was no ocular inflammation or other pathology, and metabolic work-up was normal.
Band keratopathy is typically due to deposits of gray-white calcium hydroxyapatite in Bowman’s layer. The deposition starts peripherally and moves centrally. Most cases are idiopathic, but known causes include chronic ocular inflammation, abnormalities of calcium and phosphate metabolism, silicone oil after retinal detachment repair and chronic mercury exposure.
This case is remarkable because of the reverse-C pattern as compared with the typical horizontal band. Should visual obstruction occur, topical chelation treatment with ethylenediaminetetraacetic acid (EDTA) is often effective.
BLINK SUBMISSIONS: Send us your ophthalmic image and its explanation in 150-250 words. E-mail to firstname.lastname@example.org, fax to 415- 561-8575 or mail to EyeNet Magazine, 655 Beach Street, San Francisco, CA 94109. Please note that EyeNet reserves the right to edit Blink submissions.