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A 13-year-old girl presented to us with difficulty with night vision and whitish spots in both eyes. Parents first noticed the white spots 6 months ago that were gradually increasing in size. For the past 3 months, she struggled to see in the dark and preferred to stay indoors after sunset. She was otherwise previously well. The family was vegetarian and hailed from a rural village. The child had a normal systemic examination. Ocular examination revealed bilateral, triangular chalky white plaques on bulbar conjunctivae that were not wet by the tear film (figure 1). Slit lamp examination showed that these lesions had a foamy appearance (figure 2). The child’s visual acuity and the rest of the ocular examination were normal.
Contributors AA was the clinician responsible for the care of the patient and wrote the manuscript. UF provided supervision and critically reviewed the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.