A 30-year-old patient with a history of severe alkali chemical burn to the eye 2 years ago now presents with conjunctivalisation of the cornea, chronic inflammation, and persistent epithelial defects. Limbal stem cell deficiency is suspected. Which finding best supports this diagnosis?
- A Corneal guttae on retroillumination
- B Presence of goblet cells on impression cytology of the corneal surface ✓
- C Whorl-like epithelial pattern on fluorescein staining
- D Subepithelial calcium deposition in the interpalpebral zone
Correct answer: B. Presence of goblet cells on impression cytology of the corneal surface
Explanation
Conjunctivalisation of the cornea is the hallmark of limbal stem cell deficiency. Impression cytology demonstrating goblet cells on the corneal surface confirms invasion by conjunctival epithelium. Whorl pattern is seen in amiodarone or Fabry disease. Band keratopathy shows calcium deposition. Guttae indicate endothelial dysfunction.
Reference: AAO BCSC Section 8: External Disease and Cornea, 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.