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From questions on page 423

1. Describe the slit-lamp findings (fig 1A,B) and in vivo confocal microscopy findings (fig 2A,B) of the “pigment line”

Examination reveals paracentral golden brown pigment lines arranged in a semicircular fashion around the base of the cones. The pigment line is not homogenous but made of tiny particulate deposits which extend in to the adjacent cornea on either side. Towards their ends, the lines show many finer branches converging towards the main deposit centrally (fig 1A,B). IVCM reveals 3–5 μm bright dot-like deposits within the epithelial layers and superficial stroma of cornea sparing the basement membrane (fig 2A,B) but closely associated with the subbasal nerve plexus (fig 2C).

In comparison, IVCM of a Fleischer ring also reveals bright dots, which probably represent haemosiderin/ferritin (fig 2D). These range in size from 3 to 10 μm and are mainly situated in the suprabasal and basal epithelial layers with none visible in the stroma. Moreover, the bright dots in a Fleischer ring are very scanty …

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