LAUSR

An African American woman in her 50s presented for recent-onset blurred vision in both eyes for 2 months. She endorsed mild photophobia but denied pain, redness, tearing, or discharge. There was no history of oral/genital ulcers, rashes, or atopy. Her medical history was significant for hypertension, asthma, hepatitis C, and essential tremor. Her medications include lisinopril, albuterol sulfate, and amantadine hydrochloride. She denied any previous ocular surgical procedures or trauma. She was seen 2 weeks prior and was treated with 400 mg of oral acyclovir sodium 5 times a day and sodium chloride, 5%, ointment 4 times a day. Her central corneal thickness at that time was recorded at 798 μm OD and 827 μm OS. Her best-corrected visual acuity at presentation was 20/70 OD and 20/50 OS. Her extraocular motility, pupils, and confrontation visual fields were normal. Intraocular pressures were 7 and 9 mm Hg OD and OS, respectively. An anterior segment slitlamp examination was significant for central bilateral stromal edema, Descemet folds, microcystic edema, and endothelial guttae in both eyes (Figure). There were no keratic precipitates, and the anterior chamber did not show cells or flare. Conjunctiva was white and quiet. No abnormalities were noted during an ophthalmoscopic examination. Her central corneal thickness was found to be 833 μm OD and 925 μm OS. Figure. Slitlamp photograph at presentation showing corneal edema in the left eye. Corneal edema was similar in both eyes.