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    Diagnosing CHRPE lesions can be a challenge for ODs

    Use imaging and red-free light to narrow the differential diagnosis

    A 26-year-old healthy ophthalmically asymptomatic female patient attended the University of Alabama School of Optometry clinic for a periodic ophthalmic evaluation. Her history was significant for myopic refractive correction, for which she wore soft contact lenses successfully. The medical, family, and medication histories were non-contributory. The patient denied eye pain, discharge, double-vision, color perception abnormalities, redness, itch, and previous ocular surgery.

    Exam findings

    Visual acuity was correctable to 20/20 in each eye. The anterior segment and contact lens evaluations were unremarkable in each eye.

    Her intraocular pressure measured 16 mm Hg OD and 17 mm Hg OS. Dilated fundus examination revealed a normal-appearing posterior pole in each eye and peripheral pigmented lesion in the superior temporal region of the right eye (see Figure 1).

    The pigmented characteristics of the area remained visible with red-free light. There was no perception of elevation or cellular response associated with the lesion.

    Previously from Dr. Semes: The case of the blurred disc margins


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    Optometry Times A/V