Pursuit of Osler's sign

A 58-year-old male came to the ophthalmology outpatient department with complaints of blackish discoloration in both eyes, which he noticed 6 months back. He had a history of bilateral knee pain and stiffness for 6 months, for which he was admitted in the orthopedics ward and planned for total knee...

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Main Authors: Suriya Djeamourthy, Sarala Sankar, Veni Priya Sigamani, Renuka Srinivasan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
Series:TNOA Journal of Ophthalmic Science and Research
Subjects:
Online Access:http://www.tnoajosr.com/article.asp?issn=2589-4528;year=2021;volume=59;issue=4;spage=390;epage=393;aulast=Djeamourthy
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author Suriya Djeamourthy
Sarala Sankar
Veni Priya Sigamani
Renuka Srinivasan
author_facet Suriya Djeamourthy
Sarala Sankar
Veni Priya Sigamani
Renuka Srinivasan
author_sort Suriya Djeamourthy
collection DOAJ
description A 58-year-old male came to the ophthalmology outpatient department with complaints of blackish discoloration in both eyes, which he noticed 6 months back. He had a history of bilateral knee pain and stiffness for 6 months, for which he was admitted in the orthopedics ward and planned for total knee replacement, since he was diagnosed to have bilateral OA knee. On examination, his BCVA was 6/9 in both eyes. In the interpalpebral area, there was a grayish conjunctival and scleral pigmentation seen in both the eyes in the perilimbal area at the lateral rectus insertion, which showed typical Osler's sign suggestive of alkaptonuria. Cornea was clear with a quiet anterior chamber. The pupil was round and reacting to both direct and indirect light reflexes, and there were early cataractous changes in the lens. Fundus examination with an indirect ophthalmoscope showed normal optic disc and vessels in both eyes. This is a classic case of alkaptonuria having typical signs. Many cases of alkaptonuria were diagnosed only after the development of symptoms. Scleral pigmentation usually starts during the mid-twenties; hence, being aware of this, ocular sign in alkaptonuria can lead to an early diagnosis and better outcome.
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spelling doaj.art-790b87ea1b274cea9ef379c5108820402022-12-22T04:04:13ZengWolters Kluwer Medknow PublicationsTNOA Journal of Ophthalmic Science and Research2589-45282589-45362021-01-0159439039310.4103/tjosr.tjosr_30_21Pursuit of Osler's signSuriya DjeamourthySarala SankarVeni Priya SigamaniRenuka SrinivasanA 58-year-old male came to the ophthalmology outpatient department with complaints of blackish discoloration in both eyes, which he noticed 6 months back. He had a history of bilateral knee pain and stiffness for 6 months, for which he was admitted in the orthopedics ward and planned for total knee replacement, since he was diagnosed to have bilateral OA knee. On examination, his BCVA was 6/9 in both eyes. In the interpalpebral area, there was a grayish conjunctival and scleral pigmentation seen in both the eyes in the perilimbal area at the lateral rectus insertion, which showed typical Osler's sign suggestive of alkaptonuria. Cornea was clear with a quiet anterior chamber. The pupil was round and reacting to both direct and indirect light reflexes, and there were early cataractous changes in the lens. Fundus examination with an indirect ophthalmoscope showed normal optic disc and vessels in both eyes. This is a classic case of alkaptonuria having typical signs. Many cases of alkaptonuria were diagnosed only after the development of symptoms. Scleral pigmentation usually starts during the mid-twenties; hence, being aware of this, ocular sign in alkaptonuria can lead to an early diagnosis and better outcome.http://www.tnoajosr.com/article.asp?issn=2589-4528;year=2021;volume=59;issue=4;spage=390;epage=393;aulast=Djeamourthyalkaptonuriahomogentisic acid oxidaseosler's sign
spellingShingle Suriya Djeamourthy
Sarala Sankar
Veni Priya Sigamani
Renuka Srinivasan
Pursuit of Osler's sign
TNOA Journal of Ophthalmic Science and Research
alkaptonuria
homogentisic acid oxidase
osler's sign
title Pursuit of Osler's sign
title_full Pursuit of Osler's sign
title_fullStr Pursuit of Osler's sign
title_full_unstemmed Pursuit of Osler's sign
title_short Pursuit of Osler's sign
title_sort pursuit of osler s sign
topic alkaptonuria
homogentisic acid oxidase
osler's sign
url http://www.tnoajosr.com/article.asp?issn=2589-4528;year=2021;volume=59;issue=4;spage=390;epage=393;aulast=Djeamourthy
work_keys_str_mv AT suriyadjeamourthy pursuitofoslerssign
AT saralasankar pursuitofoslerssign
AT venipriyasigamani pursuitofoslerssign
AT renukasrinivasan pursuitofoslerssign