Confoscan Images to Follow

MICROSCOPIC EXAMINATION

• Two H & E, two PAS, one B & B, one GMS, one Alcian blue, one Masson Trichrome and one Congo red stained slides are examined. Sections through the specimen show a piece of cornea with a variably thickened epithelium. There is subepithelial fibrosis with Bowman’s layer appearing disrupted; fragments of which are seen in the stroma. The stroma also shows red-staining material on Masson’s Trichrome. A few lymphocytes and plasma cells are also noted. Congo red and Alcian blue stains are negative. B & B and GMS stains are negative for any organisms associated with infectious crystalline keratopathy. PAS stain confirms the above findings.

Thickened epithelium

Subepithelial fibrosis

Fragments of Bowman’slayer

Red-staining material on Masson’s Trichrome

PAS

Congo red and Alcian blue stains are negative.

B & B and GMS stains are negative for any organisms.

Congo red

GMS

Alcian blue

B & B

Diagnosis

1) Subepithelial fibrosis.

2) Red-staining stromal deposits on Masson’s Trichrome.

Corneal epithelium, keratocytes, and endothelium should stain red; however, the most common stromal material which stains this way is hyaline. If a different material is suspected one could consider further studies.