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  • Parts a and b courtesy of Dmitry Pyatetsky, MD. Part c courtesy of Elmer Tu, MD.
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    Cornea/External Disease

    Peripheral ulcerative keratitis (PUK).a. There is guttering superiorly with corneal stromal vascularization. Filaments can also be seen at the 12 o’clock and 1 o’clock positions. The patient has been on cyclosporine eyedrops for several years for dry eye. b. The slit beam reveals at least 50% stromal loss. The deeper episcleral vessels are also inflamed with a violaceous hue. c. A patient with granulomatosis and polyangiitis (Wegener granulomatosis), scleritis, and adjacent PUK, 1 week after subconjunctival triamcinolone injection.