West Indian Punctate Keratopathy and "Puerto Rican (PR) Spots".

This study describes the clinical characteristics of a cohort of Hispanic patients living in Puerto Rico who were found to have West Indian punctate keratopathy (WIPK). This case also introduces the term "PR (Puerto Rican) spots" to describe the dots observed in the eyes of individuals with WIPK who have a documented history of residing in Puerto Rico. The methods of the study consist of a retrospective chart review of patients presenting with WIPK. The patient data were entered retrospectively into a new database and analyzed. Eighteen patients who had WIPK were identified. The median age at presentation was 60.5 years (range: 49-72); 61.1% were female. At presentation, only one patient had both eyes affected. The median number of PR spots on examination was 1 (range: 1-4). All the patients had a history of ocular disease, most frequently glaucoma (55.5%), and had lived in Puerto Rico for more than 40 years. A total of 33.3% of the patients were retired or unemployed at the time of their presentation. While the origin of these dots remains unclear, ongoing efforts to document and characterize WIPK and PR spots will persist, with the aim of enhancing our understanding of this clinical entity.

Managing a Pigmented Corneal Ulcer in a 58-Year-Old Patient.

We report on a case study involving a 58-year-old male with a pigmented corneal ulcer. The patient presented with a two-month history of an unresolved corneal ulcer in the oculus sinister (OS), accompanied by increasing ocular discomfort. His best corrected visual acuity (BCVA) was 20/20 oculus dexter and hand motion OS. Examination of OS revealed mild conjunctival injection, diffuse corneal edema, and the presence of a central pigmented lesion. Microbiological analysis via culture identified the causative agent as Ochroconis fungi, belonging to the dematiaceous species. Subsequently, the patient's condition was managed through a comprehensive regimen that included multiple topical antifungal agents, a topical antibiotic, and povidone-iodine drops. After two months of treatment, the patient exhibited improvement in his condition. His BCVA improved to counting fingers at a distance of two feet OS.