Case Study: October 2008

A 55 year old female presents with bilateral red eyes. A biopsy of the bulbar conjunctiva shows a distinctive appearance. This is shown by the arrows in the figure.


1. What is shown by the white arrows?
2. Which other features does the figure show?
3. What is the likeliest diagnosis?

Click to show answers

1. Intraepithelial eosinophils.
2. Epithelial spongiosis, some basal epithelial vacuolar change and stromal inflammation also containing eosinophils.
3. Allergic conjunctivitis. The clinical entities include: acute allergic rhinoconjunctivitis, vernal keratoconjuntivitis, atopic keratoconjunctivitis and giant papillary conjunctivitis.