Phthisis bulbi caused by late congenital syphilis untreated until adulthood.

PURPOSE: To report a case of phthisis bulbi resulting from late congenital syphilis untreated until adulthood. DESIGN: Observational case report. METHODS: We report clinical and laboratory evaluations of a 43-year-old woman who presented with a palpebral ulcer of the right eye. RESULTS: The patient had a gummatous palpebral ulcer and a phthisis bulbi in the right eye and a gumma on the left eyelid. A silent interstitial keratitis of the left eye was detected. The patient had hearing loss in the right ear, her nose was missing, and her right leg had been amputated. Treponemal pallidum hemagglutination (TPHA) test was positive. Although we administered intensive oral penicillin, the clinical symptoms of the patient did not improve. CONCLUSIONS: This is a rare case of phthisis bulbi resulting from late congenital syphilis. We emphasize that treatment for late congenital syphilis must be carried out early and completely.

In vivo confocal microscopy in the patients with cornea farinata.

PURPOSE: To report in vivo corneal confocal microscopic findings of patients with cornea farinata. PATIENTS AND METHODS: Two unrelated patients, a 47-year-old man and a 77-year-old woman, with cornea farinata were studied. Examination with a confocal microscope was performed in addition to routine slit-lamp biomicroscopy. RESULTS: In both cases, slit-lamp biomicroscopy showed numerous small, faint opacities in the deep stroma in both eyes. Using confocal microscopy, highly reflective small particles were observed in the cytoplasm of keratocytes in the deep stroma adjacent to the corneal endothelial layer. No abnormalities could be detected in the epithelial layer, in the mid-stromal layer, at the level of Descemet's membrane, and in the endothelial layer. CONCLUSIONS: In vivo corneal confocal microscopy is useful for observing stromal abnormalities in cornea farinata. Further investigation of posterior stromal opacities using confocal microscopy may be useful to understand and differentiate various corneal conditions involving primarily deep stromal layers.

Successful management of conjunctival intraepithelial neoplasia by interferon alpha-2b.

BACKGROUND: Interferon alpha-2b (IFN alpha 2b) was recently shown to be effective as an alternative therapy for conjunctival intraepithelial neoplasia (CIN). Herein, we report our successful management of CIN by the use of IFN alpha 2b. CASE: A 73-year-old woman presented with a complaint of irritation due to a tumorous lesion in her left eye. Slit-lamp microscope examination revealed a tumorous lesion involving the bulbar and palpebral conjunctiva as well as the limbus, from the 3-o'clock position to the 8-o'clock position. She had already undergone cryotherapy in the same eye in another hospital, twice for a lesion on the lower tarsal conjunctiva and once for a lesion on the upper tarsal conjunctiva. The histological diagnosis had been CIN. OBSERVATIONS: In treating this patient, IFN alpha 2b was injected subconjunctivally twice and also applied as eye drops for 12 weeks. Two weeks after the initial treatment, the tumorous lesion disappeared. During a 1-year follow-up period, no recurrence was noted. CONCLUSION: Topical and subconjunctival IFN alpha 2b is a valuable treatment option for CIN.