A 65-year-old patient presents with bilateral chronic ocular surface discomfort, redness, and gradual vision loss. Slit-lamp reveals a horizontal band of grey-white opacification across the interpalpebral zone of the cornea, with a Swiss cheese appearance. Serum calcium and phosphate are normal. What is the most likely diagnosis?
- A Salzmann nodular degeneration
- B Band keratopathy ✓
- C Climatic droplet keratopathy
- D Epithelial basement membrane dystrophy
Correct answer: B. Band keratopathy
Explanation
Band keratopathy shows calcium deposition in Bowman layer and anterior stroma in the interpalpebral zone, with a Swiss cheese appearance from holes where nerves traverse. It can occur with chronic ocular inflammation (uveitis, phthisis) even with normal serum calcium. Salzmann nodules are blue-white elevated nodules. Climatic droplet keratopathy is from UV exposure in tropical climates. EBMD shows dot, map, and fingerprint patterns.
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.