University of Iowa Health Care

Ophthalmology and Visual Sciences

EyeRounds Online Atlas of Ophthalmology

HISTORICAL ARCHIVE: Pathology, Cornea, External Disease, Tumors, Neoplasms

For more recent images, see the Atlas Index

Click on the thumbnail images for a larger photograph and description of each case

*Dr. Caccamise generously shared his images of patients taken while operating during the "eye season" in rural India as well as those from his private practice during the 1960's and 1970's. Many of his images are significant for their historical perspective and for techniques and conditions seen in settings in undeveloped areas.

Photograph Diagnosis
abscess of meibomian gland
acute angular meibomitis (meibomianitis) with marked chemosis, lid edema, and pain OS
acute hemorrhagic conjunctivitis
acute meibomianitis marginalis
acute mucopurulent bacterial conjunctivitis
adherent leukoma adherent leukoma
Acanthamoeba keratitis adherent leukoma due to perforating corneal injury to only eye
albinism in a young Indian whose father is normally deeply pigmented
albinism in India patients- father normal, son albinism
allergic blepharitis
allergic conjunctivitis
allergic corneal reaction
allergic follicular conjunctivitis
alopecia totalis with loss of eyebrows and eyelashes
an active PKC lesion and a post-PKC pseudopterygium
angular conjunctivitis
angular conjunctivitis OD
another example of a Kohl-pigmented Bitot's spot
anterior ectasiae/anterior scleral staphlomata
aphakic bullous keratopathy aphakic bullous keratopathy
arcus senilis, prominent
asteroid hyalitis
atopic dermatis with cataracta complicata
atrophia bulbi with leukomatous cornea that is showing fatty and calcium infiltration. atrophia bulbi with leukomatous cornea that is showing fatty and calcium infiltration.
atypically located limbal girdle atypically located limbal girdle
bacterial conjunctivitis
band keratopathy
bandshaped keratopathy
bandshaped keratopathy OD, more advanced
basal cell carcinoma
basal cell carcinoma - left lower lid
basal cell carcinoma - lower lid
basal cell carcinoma: a classic example
Beesting keratopathy
benign lymphocytic infiltration - lacrimal gland - OS
Bilateral orbital disease- lymphomata
Bilateral orbital lymphomata
Bitot's spot, The xerotic bulbar conjunctival base of a
Bitot's spot in Vitamin A deficiency, blackened
blepharitis and meibomian gland dysfunction
blindness from bilateral corneal lepromata
Blindness-mother had chickenpox during 1st trimester
bloodstaining of the cornea
Blood staining of the cornea following cataract surgery, classic
Blood staining of the cornea
Bowen's disease invading cornea at 9:00 o'clock OD
bulbar conjunctival cyst
bulbar conjunctival epithelial inclusion cyst
bulbar conjunctival lymph cyst
bulbar conjunctival nevus
Bulbar subconjunctival hemorrhage
bullous keratopathy following intracapsular cataract surgery
Bullous keratopathy following intracapsular cataract surgery -
carcinoma of the conjunctiva
caruncle: abscess of caruncle
Cataract Historical archive: There are a large number of cataract photos in the archive, they warranted their own page
Caucasian with nevus of Ota
central corneal leukoma
central corneal with a partial arcus senilis
chemical burn: porcelainized scarring of the cornea
Chlamydia trachomatis infection Chlamydia trachomatis infection
chronic blepharokeratoconjunctivitis associated with rosacea compounded by alcoholism
chronic dacryocysitis with abscess formation
chronic dacryocystitis OS
Ciliary staphyloma with descemetocele
classic nevus of Ota
classic xanthelasma - inner upper lid OU
comedones - skin near lateral canthus
complete arcus senilis (gerontoxon)
Confocal microscopy in fungal keratitis Confocal microscopy in fungal keratitis
Congenital absence of the lacrimal puncta associated with alacrima and aptyalism OU
congenital coloboma of the iris OD
congenital ichthyosis with bilateral ectropion
congenital syphilis with interstitial keratitis
Conjunctiva: bulbar conjunctival papilloma
conjunctiva: epithelial inclusion cyst - inferior fornix
conjunctiva: marked chemosis OD
conjunctiva: pinguecula
conjunctival cyst: epithelial inclusion cyst
conjunctival cyst: huge
conjunctival implantation cyst following cataract surgery
Conjunctivitis: with unusual ridge reaction
contact lens overwear reaction
cornea: aniso-cornea: microcornea OD, normal cornea OS
cornea: corneal abrasion with reflex spastic miosis
cornea: familial corneal epithelial dystrophy
Cornea: familial dystrophy of the cornea with initial epithelial edema followed years later by fatty infiltration
Cornea: familial dystrophy of the cornea with initial epithelial edema followed years later by fatty infiltration 2
cornea: interstitial keratitis with congenital syphilis
cornea: keratoconus with apical scarring
cornea: leukomatous scar due to hypopyon ulcer with perforation.
cornea: macular corneal scar - a residual of a noe inactive keratitis
cornea: recurrent corneal abrasion
cornea: smallpox with symblepharon to cornea and bulbar conjunctiva OD
cornea: stained marginal corneal abrasion between superior limbus and light reflex.
cornea: staphyloma OD with xeroderma - vitamin A deficiency
Cornea: staphyloma resulting from perforating hypopyon ulcer
cornea: total corneal decompensation with diffuse epithelial edema following cataract surgery
corneal contact lens
corneal erosion OS
Corneal leukoma with iridodialysis
corneal macular scar with neovascularization of the superior cornea
corneal staphyloma with keratomalacia OU
corneoconjunctival (limbal) dermoid tumor
crusting blepharitis with extension into the brows-OU
crusting blepharitis-vitamin A deficiency
cyst at limbus following pterrygium surgery
cyst of a gland of Moll (a ciliary gland)
Cyst: bulbar conjunctival lymph cyst
cyst: meibomian gland retention cyst with pemphigoid
Cyst: bulbar conjunctival lymph cyst
cyst-retention cyst of a gland of Moll
cystic pigmented nevus of the bulbar conjunctiva
cystic pigmented nevus of the bulbar conjunctiva in the palpebral fissure zone
cytoid cicatrix of the limbus
dacryocystorhinostomy-sutures visible os
dendritic keratitis - correction of photos for cache
dendritic keratitis - stained
dendritic keratitis HSV - active
dendritic keratitis: after being scrubbed with ether on a q-tip
dermoid tumor of cornea
Descemetocele: in a patient in India 1962
Descemetocele: potential descemetocele
diffuse calcareous keratopathy
Disciform keratitis (HSV)-active with neovascularization
Disciform keratitis due to herpes simplex virus - active stage with neovascularization of cornea.
disciform keratitis due to herpes simplex virus - inactive stage
disciform keratitis due to herpes simplex virus - neovascularized
disciform keratitis with neovasc
dyskeratosis/ Bowen's disease/ carcinoma in situ - with leukoplakia: an earlier photo of this case is in this Atlas. This second photo provides a better view of the lesion
Ectropion-right upper lid from burn
ectropion uveae OD
elephantiasis nostras OD
elephantiasis nostras of rt. upper lid
elephantiasis nostras: postop - excision of tissue of upper lid OD
episcleritis - bilateral - in a scholastic with ulcerative colitis
episcleritis with keratitis
erratic tattoo of corneal leukoma
examinig a 5mos-old child with a perforated cornea due to keratomalacia caused by vitamin A deficiency
exophthalmos: endocrine type
exophthalmus with Graves' Disease (hyperthyroidism)
exophthalmus, asymmetrical bilateral
familial corneal dystrophy
fatty and calcareous degeneration of the cornea
fatty degeneration of the cornea
filamentary keratitis - a second view
filamentary keratitis
florid follicular formation in acute trachoma
florid keratomalacia in an infant -due to vitamin A deficiency
follicles involving the limbus-each is a pre-cursor to a Herbert's pit
foreign body - rust deposit in cornea at 7 o'clock overlying the iris frill in that region
freckled iris with iris nevus
fresh, superficial burn of the cornea
frontal view scrofula scars upper chest and rt preauricular with rt lid edema
Fuchs' epithelial-endothelial corneal dystrophy following cataract surgery
Fuchs epithelial-endothelial corneal dystrophy with central ruptured epithelial bullae
Fuchs' epithelial-endothelial dystrophy of the cornea OD
Giant Papillary Conjunctivitis
Granulation tissue exuding from site of recent chalazion surgery
granuloma pyogenicum
granuloma pyogenicum
Groenouw I granular corneal dystrophy
Groenouw's granular dystrophy I
Groenouw's Type I Granular corneal dystrophy
Groenblad-Stranberg syndrome- pseudoxanthoma elastcum with andioid streaks of the fundus oculi
healed destructive ophthalmomyiasis externa
healing nodular episcleritis
heavily pigmented iris lesion (differential diagnosis of)
hemangioma of lid
hemangioma of lid margin
herpes simplex I of the lid
herpes simplex virus disciform keratitis - calcified
herpes zoster ophthalmicus
herpes zoster ophthalmicus - a cache
herpes zoster ophthalmicus with Hutchinson's sign
hyperthyroidism: lid retraction OU with exophthalmos OU
hyperthyroidism: post-radioactive iodine
hypopyon ulcer - initial stage
hypopyon ulcer / ulcus serpens with hypopyon
hyposphagma (subconjunctival hemorrhage) after retching
internal hordeolum - a meibomian abscess
internal sty: also called abscess of meibomian gland or subacute meibomianitis (meibomitis)
Interstitial keratitis due to congenital syphilis
interstitial keratitis with band-shaped keratopathy
iris lesion- leiomyoma or nevus
keratitis- an autoimmune response
keratitis with scleral thinning from previous nodular scleritis
keratitis: allergic or autoimmune basis
keratitis: sclerosing keratis - a further discussion
keratoconus - a side view
Keratoconus with Munson's sign
keratomalacia - an extreme stage with cornea and ciliary body staphylomata of an extreme degree
keratomalacia with lens tamponade
Knife injury OD
Lacrimal gland tumor OS
lacrimal gland tumor- mixed
lash entrapped in superior punctum
lash entrapped superior punctum OS
left frontal sinusitis with draining fistula
lens tamponade of corneal defect
leprosy: patient is blind due to leprotic uveitis and keratitis
leukoma from hypopyon ulcer
leukoma: adherent leukoma
leukomatous cornea with positive Seidel sign with fluorescein solution
Leukomatous cornea heavy neovascularization
leukomatous corneal ulcer scars with fatty infiltration
Lid lesions
lid margin cyst of ciliary gland of Moll
lid margin lesion
lid retraction due to thyroid dysfunction
Lid: abscess of meibomian gland (acute meibomitis/ meibomianitis)
lids: blepharitis marginalis - a typical case as seen in the USA
limbal conjunctival nevus
Limbal dyskeratosis
lime burn of the cornea OS
localized, nodular keratitis
luxated lens
lymphangiectasia conjunctivae
lymphangiectasia hemorrhagica conjunctivae OD
MacCallan's classification of trachoma
macula of the cornea vs nebula and leukoma
madarosis/ milphosis: loss of eyelashes in a patient with rosacea
malignant endocrine (thyrotropic) exophthalmos
marginal keratitis OD
marginal keratitis with rosacea
meibomian gland abscess / internal sty
meibomian gland orefice plugs
meibomian gland: abscess of meibomian gland internal sty internal hordeolum
melanosis oculi
metaherpetic HSV keratitis
metaherpetic keratitis
metaherpetic keratitis - a second case
microcornea and heterochromia
microcornea OU
microcornea OU with prominent pingueculae OU
Microcornea with after-cataract following needling of congenital cataract
microcornea with microphthalmos (nanophthalmos)
microcornea with microphthalmos (nanophthalmos)
microcornea, coloboma of iris, and cataract
melanosis oculi OD
melanosis oculi wih pigmentation of tarsal conjunctiva near lid margin
Melanosis, Racial
milia of skin of upper lid
multiple meibomian infarcts
multiple meibomian infarcts - superior tarsus OU
mycotic abscess of cornea with hypopyon
nasal pterygium, partial arcus senilis, and iridoschisis superiorly
Nevus of Ota - Caucasian patient
nevus of Ota - the complete complex
nevus: dermal nevus with hair
nidus of tarsal conjunctival concretions or meibomian infarct material
nodular episcleritis
nodular episcleritis
nodular scleritis with keratitis
nodular scleritis: residual scleral thinning
ocular pemphigoid
ocular pemphigoid or essential shrinkage of the conjunctiva
ocular pemphigoid with entropion and trichiasis
opaque cornea as a result of a perforating, linear laceration due to broken glass
ophthalmia nodosa
optical iridectomy - a part of the history of ophthalmic surgery
orbit: marked orbital cellulitis OS
Orbital lymphoma-OU
osteomyelitis fistula of frontal bone (related to sinusitis) with adherenco of skin of upperlid producing an ectropion with epidermalization of the exposed palpebral conjunctiva
palpebral vernal conjunctivitis
papilloma - right upper lid
papilloma of lid
pedunculated papilloma of the caruncle
pemphigoid (essential shrinkage of the conjunctiva)
pemphigoid/essential shrinkage of the conjunctiva
perforating corneal injury with iridectomy, repaired
phlyctenular keratoconjunctivitis
phlyctenular keratoconjunctivitis
Phthisis bulbi following perforating smallpox ulcus serpens
phthisis bulbi: unique cuff link deformation of cornea caused by smallpox - photo 1966
phylectenular keratoconjunctivitis - PKC
Pigmentation of conjunctiva by mascara
pigmentation of plica semilunaris
pigmented nevi of lid margins
pigmented nevus of caruncle OD
pigmented nevus of conjunctiva OS
pigmented nevus of iris
pigmented nevus of iris
pigmented nevus of lower lid
pigmented papilloma with hair
pilosebaceous lid margin cyst
pinguecula - inflamed
pinguecula- starting point for a pterygium
pingueculitis: succulent pinguecula
PKC (phlyctenular keratoconjunctivis)-OS
PKC (phlyctenular keratoconjunctivis) : a classic example in a patient at the Eye Clinic in India in 1968.
PKC (phlyctenular keratoconjunctivis), the facies
PKC (phlyctenular keratoconjunctivis) with a giant phlyctenule
poliosis of lashes
Post-op Leprosy patient
pseudopterygium / Salzmann's nodular corneal degeneration
pseudoxanthoma elasicum - upper forearm/ Groenblad-Strandberg Syndrome
pterygium - active - OD
pterygium - temporal and nasal pterygia in an eye
pterygium: a prototypical example
pterygium operations, unsuccessful
ptosis trachomatosa
purulent dacryocystitis O.S.
purulent dacryocystitis OD
rust foreign body in cornea
rule out Bowen's disease
ruptured chronic dacryocystitis OS
Salzmann's nodular degeneration/dystrophy of the cornea
Salzmann's nodular degeneration/dystrophy- a 2nd case
scar of healed corneal ulcer with calcification
Schirmer test
scissors perforation of cornea, adherent leukoma, arcus senilis, and prominent pinguecula
sclera: residual plaque of thinned sclera following nodular scleritis.
scleral hyaline plaque
sclerosing keratitis
sclerosing keratitis with calcification-inactive
scrofula with lid edema O.D.
scrofula/fungating cervical tbc lymphadenitis
sebaceous cyst at outer canthal region
senile spastic entropion-rt lower lid
skin lesion of right lower lid a keratotic lesion that has become irritated
smallpox - bilateral phthisis bulbi
Smallpox - vascularized leukoma OD and adherent leukoma OS
smallpox and trachoma: leukoma of each cornea trichiasis, and facial pock marks.
smallpox blindness - destroyed corneas-result of hypopyon ulcer ou
smallpox: central leukomatous corneal scar OU
Smallpox: extensively pocked face and blind from bilateral hypopyon ulcer - 1964
smallpox: heavily vascularized, large adherent leukoma OD and smaller off-center adherent leukoma OS
smallpox: leukoma OS
smallpox: marked staphyloma of cornea OU 1962
smallpox: phthisis bulbi OU - no LP
smallpox: total blindness resulting from phthisis bulbi OU due to perforating hypopyon ulcers during smallpox attack.
stained- herpes simplex I of the cornea
staphyloma OS
Staphyloma, huge, in a young boy OD
Staphyloma: huge anterior scleral staphyloma
staphlyoma of the cornea, vascularized- the result of a smallpox attack
Stevens-Johnson Syndrome
striate keratitis following intracapsular cataract surgery, pronounced
subsiding acute meibomianitis going into the chalazion stage
symblepharon caused by burn due to molten metal.
symblepharon at site of perforating ulcer of cornea
symblepharon/ pseudopterygium/ cicatricial pterygium
symblepharon, total OU
syphilis: congenital interstitial keratitis
Syphilis: interstitial keratitis in congenital syphilis, inactive
Syphilis and trachoma: tertiary syphilis with gumma distruction of nose also s-curve of right upper lid due to trachoma.
syringocystadenomata (closeup)
syringocystadenomata of lids
tattooing of the cornea- a part of eye history
tattooed cornea
tattooed leukomatous cornea in an eye that is going into phthisis bulbi following unsuccessful cataract surgery
tattooing of cornea : same two photographs under different lighting and contrast to make tattooed areas more conspicuous
temporal and nasal pterygia
temporal pterygium OD
thyroid disease - retraction of superior lid OS
Trachoma - follicles of stage I of MacCallan's classification
trachoma with extensive superior tarsal conjunctival scarring
trachoma with symblepharon
trachoma with xerophthalmia - coexistence of trachoma with vitamin A deficiency
Trachoma: facies of active trachoma in a rural patient in India
trachoma: irregular scarring of tarsal conjunctiva
trachoma: limbal arcade vs pannus
trachoma: pemphigoid-like trachoma with trichiasis
trachoma: trichiasis, outward convexity of the superior tarsus, and tylosis/ pachyblepharon.
trachoma: trichiasis, pannus, and corneal scarring
trachoma: typical pannus of trachoma
trachomatous trichiasis rt upper led
trachoma with pannus crassus
trachoma: a perfect photo of established trachoma with conjunctivitis, florid pannus, corneal scarring, and trichiasis
tropical eosinophilia with bulbar conjunctival hyperemia, both eyes
tuberose (tuberous) sclerosis: Pringle's Disease/ adenoma sebaceum - left facial view
tuberous sclerosis
tylosis of lower lid with slight ectropion. There is a temporal Bitot's spot.
Varicella/ chickenpox: loss of lashes (madarosis) lower lid
varices, orbital OS
varices, orbital
varices,retrobulbar - left orbit
varices, retrobulbar - left orbit
viral keratoconjunctivitis
viral keratoconjunctivitis
vitamin A deficiency
Vitamin A deficiency and its ocular manifestations
Vitamin A deficiency: Buphthalmos OD and phthisis bulbi OS
vitamin A deficiency: florid xerophthalmia
Vitamin A deficiency: potential descemetocele in vitamin A deficienct with xerophthalmia
Vitamin A deficiency: profound xerophthalmia due to vitamin A deficiency
vitamin A deficiency with left cervical tuberculous lymphadenitis(scrofula)
Vitamin A deficiency: xerophthalmia and symblepharon formation
vitamin A deficiency with xerophthalmia and spastic entropion with trichiasis OS
Vitamin A deficiency with xerosis conjunctivae and a nasal Bitot's spot
vitamin A deficiency: temporal Bitot's spot
Vitamin A deficiency: temporal Bitot's spot OD with keratomalacia producing a xerotic staphyloma of the cornea
Vitamin A deficiency: Temporal Bitot's spot, slight ectropion lower lid, tylosis, and nuclear cataract
vitamin A deficiency: xerophthalmia with corneal scarring and xeroderma
Vitiligo in India/Indian
vitiligo of the iris
vitiligo of iris inferiorly
xanthelasma - left upper lid - closeup of previous Atlas photo
xanthoma (xanthelasma) of the lids
xanthoma palpebrarum
xerosis conjuntivae
xerotic plaque in center of neovascularized corneal leukoma

Creative Commons License
Ophthalmic Atlas Images by, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.


last updated: 8/1/2014
  Share this page: