A 78-year-old Caucasian female, with a history of hypothyroidism, osteoporosis and open-angle glaucoma, presents with left eyelid redness and irritation for the past month. This irritation is not associated with eye pain or vision changes. There is some mild associated tearing and redness, but no discharge. Family history, social history and allergies are non-contributory. Review of systems is non-contributory.

Vision, pupil exam, intraocular pressure, motility and confrontation fields are all normal in both eyes. External examination is shown in the photos below. Anterior segment exam is notable only for mild conjunctival injection nasally in the left eye and mild punctate epithelial defects nasally in the left cornea. Dilated fundus exam is only notable for mild optic nerve cupping in both eyes.

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