Quiz: Intermittent Stabbing Left Eye Pain

This 69-year-old male presented with a 2 month history of intermittent stabbing left eye pain relieved by non-steroidal anti-inflammatories. He also complained of photophobia and slowly progressive decline in vision. Ocular history was notable for open-angle glaucoma affecting both eyes. Similar events occurred in his right eye several years prior. Medical history was positive for recurrent sinusitis and epistaxis. The remainder of the medical, surgical, family, and social histories are non-contributory.

Exam shows vision of: bare Light Perception right eye and Hand Motions at 1 foot in left eye. Intraocular pressures were: “unable to read” right eye, 16 left eye. External exam shows normal eyelids.

TYK 12.01.18 (2)

Examination of the right eye reveals it to be pre-phthisical with complete corneal vascularization. Photos of the left eye are shown below; slit lamp exam shows peripheral thinning and vascularization of the cornea without infiltrate. The anterior chamber shows keratic precipitates and mild cellular reaction. There are iris synechiae and a mild cataract. Dilated fundus exam of the left eye had a limited view but appeared normal as was B-scan ultrasound.

TYK 12.01.18 (1)

Last Updated: October 31, 2022

6 thoughts on “Quiz: Intermittent Stabbing Left Eye Pain”

    • Yes. PUK is associated with many autoimmune disorders including granulomatosis with polyangiitis (GPA) formerly called Wegener’s.

    • Good question currently I’m dealing with a patient with similar Anterior segment finding and Lab result pending so it is really help full thanks


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