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It sounds like something straight out of a sci-fi movie.
But this "gelatinous" mass that protrudes from the eye of a man is not a special effect in the latest zombie movie.
The 74-year-old unidentified young man was referred to a cancer clinic when a 10 x 10 mm white piece was formed at the place where his right pupil should be.
The mass appeared two years after his cataract surgery, which left him a thick scar on the cornea.
The doctors removed the mass, which later turned out to be a corneal keloid. These occur when the structures that make up this part of the eye become "random," often after a surgical operation or injury.
The man is doing well after the operation to remove the mass, but still has trouble seeing the affected eye.
The 74-year-old – who was not named – was referred to a cancer clinic when a white ball of 10 x 10 mm (photo) formed in place of his right pupil. The mass developed two years after undergoing cataract surgery and was later identified as a corneal keloid.
The man was cared for by a team from the Duke Eye Center, led by Dr. Nikolas Raufi, of the Ophthalmology Residency Program.
Dr. Raufi was the lead author of the unusual case report published in the prestigious journal JAMA Ophthalmology.
The man told doctors that he had already suffered from herpetic keratitis. This occurs when the herpes virus – which can manifest itself as an STI or cold sores – spreads to the eyes.
He had also undergone a cataract surgery on the same eye two years earlier.
This procedure was complicated by bullous keratopathy, which occurs when fluid accumulates in the cornea. The cornea is the outermost layer of the eye, which plays an important role in focusing the vision.
The bullous keratopathy of the man was not treated, leaving him with a swollen and cloudy cornea covered with blisters.
He later noticed a scar on his cornea, which gradually thickened over the course of six months.
The patient was finally left with the white lesion, which even had its own blood supply.
The mass was so great that the doctors were unable to see the anterior segment of the human, which constitutes the anterior third of the eye, and contains the cornea, iris and lens.
An eye exam also detected a cleft between the man's cornea and his lesion, which doctors estimated to be no more than 1.5 mm deep.
This prompted them to be more cautious when removing the lesion.
An ultrasound revealed that he had a 1.5 mm (photo) slit in the eye, between the cornea and the lesion. The doctors had to be particularly vigilant when withdrawing the mass
Once removed, the doctors identified the mass as a keloid of the cornea.
Fifteen days after the operation, the man was still unable to count the number of fingers that were presented to him. His eye was also bloodshot and cloudy.
By the 16th week, the man could see a restless hand three feet in front of him, but his vision was still blurry.
"It goes subjectively well but will be followed for the development of recurrence," wrote the authors.
Corneal keloids are so rare that only about 80 cases have been reported since the phenomenon was identified in 1865.
They have been defined as a "random arrangement of fibroblasts, bundles of collagen and blood vessels."
If the lesions appear in both eyes, they are normally related to congenital Lowe syndrome or Rubenstein-Taybi syndrome.
The cases that occur of themselves are usually due to an injury to the eye, an infection or surgery.
Dr. John Hovanesian – a clinical spokesperson for the American Academy of Ophthalmology – has however pointed out that corneal keloids are an "extremely rare complication" of surgery.
"Many ophthalmologists have never seen keloid of the cornea because it's such a rare thing," he told Live Science.
Despite the name that connects them to keloids – raised scars – of the skin, the authors wrote "no link was found with the cutaneous keloids".
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