Ocular Surface Disease: MD Winner

Case Information

A 59-year-old Caucasian male presented with right eye redness and irritation. He has a medical history significant for optic neuropathy in both eyes and migraines with visual aura. Pretreatment exam showed a conjunctival lesion and a peripheral corneal opacity temporally, with further OCT showing hyperreflectivity, epithelial thickening and presence of an abrupt transition zone corresponding to the corneal lesion.

Medical History:

Arrhythmia, basal cell carcinoma (treated with fluorouracil), migraine. Avid sailor with occasional use of sunscreen.

Concomitant Medications:

None

Diagnosis:

Ocular surface squamous neoplasia (OSSN)

Treatment:

3 cycles of 5 fluorouracil QID x 1 week then 3-week break followed by 3 cycles of MMC 0.04%, QID x 4 weeks then 2 weeks off