Tamoxifen keratopathy as seen with in-vivo confocal microscopy.

Tamoxifen is a triphenylethylene non-steroidal oestrogen antagonist widely used in oestrogen receptor-positive breast cancer, with well-documented ocular side-effects. Here we report a corneal confocal microscopy finding of a patient on low-dose tamoxifen. We believe that this is the first case report of a patient on low-dose tamoxifen with demonstrable corneal stromal crystalline deposits with confocal microscopy, but clinically asymptomatic with unremarkable corneal findings on cursory slit lamp examination. In summary, confocal microscopy is a useful adjunct in monitoring tamoxifen crystalline keratopathy, and helps detect subclinical deposits not visible/detected on slit lamp examination.

Corneal Endothelium in Brown-McLean syndrome: in-vivo confocal microscopy finding.

When Brown-McLean syndrome (BMS) was first described, there was no confocal microscopy to document corneal endothelial status, and it was understood as a disease entity involving a diseased endothelial layer. In the advent of confocal microscopy demonstrating healthy endothelium in BMS within the affected cornea, it can be inferred that BMS is a spectrum of disease ranging from healthy to decompensated corneal endothelium, rather than just a specific disease entity. Here we report a case of BMS with normal healthy corneal endothelium using corneal confocal microscopy. Any patient with BMS should be followed up to observe for any disease progression and should be educated regarding the signs and symptoms of corneal surface problems. Confocal microscopy documentation is a convenient and informative way and should form part of the follow-up of any BMS patient.

Minocycline induced conjunctival autofluorescence deposition.

Minocycline can cause palpebral conjunctival greyish deposits in which autofluorescence can be readily demonstrated. We believe that this is a first report of the demonstration of in-vivo conjunctival autofluorescence of palpebral conjunctival minocycline deposit. In conclusion, minocycline deposit can be shown clinically without the need of an invasive biopsy procedure in patients with a history of blepharitis on long-term tetracycline group of medication presenting with palpebral conjunctival deposits.

Xerophthalmia because of dietary-induced vitamin a deficiency in a young Scottish man.

Vitamin A deficiency causing xerophthalmia, although a major public health issue in sub-Saharan Africa, is rarely seen in people living in developed countries. In such cases, it is usually associated with severe malnutrition caused by intestinal disorders, such as celiac disease, pancreatitis, or extensive bowel surgery. Dietary-induced vitamin A deficiency leading to xerophthalmia has rarely been reported in the United Kingdom. In this case, we report on a young man who presented with corneal xerosis and whose history of corneal ulceration had not been linked to his restricted diet, which resulted in vitamin A deficiency. Unlike other cases, this young man had no history of psychiatric illness and led a normal active lifestyle.

Capsule endoscopy findings in patients with suspected Crohn's disease and biochemical markers of inflammation.

BACKGROUND: Because it provides a direct view of superficial lesions in the small bowel, capsule endoscopy is a promising diagnostic tool for studying patients with suspected Crohn's disease undetected by conventional modalities. AIM: To assess the role of capsule endoscopy in the diagnosis of patients with suspected Crohn's disease. PATIENTS AND METHODS: Thirty-eight patients (16 males, mean age 46.2 years) with suspected Crohn's disease but negative at conventional imaging were examined using capsule endoscopy. They were divided into 2 groups: 12 patients with ongoing symptoms (Group 1), and 26 with ongoing symptoms and biochemical markers of inflammation (Group 2). Capsule endoscopy findings were classified as diagnostic (multiple erosions/ulcerations), suspicious (