PMC8784459_01
Corneal photo of the right eye.
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F1
The lesion was located in the paracentral cornea with loose, irregular corneal epithelia, haze at the base, and corneal edema (Fig. 1).
(a) Corneal hyperreflective cyst surrounded by a hyporeflective halo. Fusiform cells with hyperreflective cytosol that were similar to shedding epithelial cells aside from non-hexagonal shape can be seen among the wing cells; (b) Hyperreflective tissue resembling the rolled basement membrane seen in basement membrane dystrophy; (c) Increased reflectivity in the anterior stromal level; (d) Activated anterior stromal keratocytes forming a honeycomb pattern.
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F2
Cornea Module, Heidelberg Engineering GmbH, Heidelberg, Germany) revealed hyper-reflective cysts of 20-25 microm in diameter surrounded by a hyporeflective halo (Fig. 2a). The presence of unexpected fusiform cells with bright cytoplasm in the wing cell layer, which, aside from the shape, resembled epithelial cell shedding, prompted the suspicion of trophozoites (Fig. 2a). CCM also revealed activated keratocytes in a honeycomb pattern, hyper-reflectivity in the basement membrane and the anterior stromal level (Fig. 2 b-d). CCM images of the left eye were normal.
(a) Corneal photo of the patient on the 10th day; (b) Corneal confocal microscopy image at the wing cell level demonstrating a normal, healthy appearance.
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F3
Only artificial tears were used thereafter (Fig. 3a, 3b).