title: Delayed mustard gas keratopathy: clinical findings and confocal microscopy.
abstract: OBJECTIVE
  To describe the clinical manifestations and confocal microscopic findings in a patient with delayed mustard gas keratopathy.
  
  
  METHODS
  Case report. A 32-year-old veteran who had participated in the Iran Iraq conflict was exposed to mustard gas in 1988. Ocular abnormalities in 1996 and 1998 and corneal confocal microscopic findings in 1998 are presented.
  
  
  RESULTS
  In 1996, slit-lamp examination disclosed bilateral limbal changes with tortuous blood vessels and full-thickness corneal alterations. In 1998, the right eye had porcelain-white episcleral changes and adjacent peripheral ulcerative keratopathy. Confocal microscopy demonstrated irregular-appearing epithelial and basal epithelial cells. The anterior stroma was remarkable for spindle-like keratocytes, diffuse fibrillar inhomogeneities and the presence of highly reflective material.
  
  
  CONCLUSIONS
  Mustard gas keratopathy is a uncommon cause of ocular damage, but it may lead to delayed ocular damage.
authors.affiliation: Department of Ophthalmology, Charité, Berlin, Germany. uwe.pleyer@charite.de
authors.forename: U
authors.initials: U
authors.lastname: Pleyer
authors.forename: Z
authors.initials: Z
authors.lastname: Sherif
authors.forename: H
authors.initials: H
authors.lastname: Baatz
authors.forename: C
authors.initials: C
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D002618:Chemical Warfare; D003315:Cornea / Q000473:pathology; D003316:Corneal Diseases / Q000139:chemically induced* / Q000473:pathology* / Q000503:physiopathology; D003320:Corneal Ulcer / Q000139:chemically induced; D006801:Humans; D019156:Indian Ocean; D008297:Male; D018613:Microscopy, Confocal; D009151:Mustard Gas; D012590:Sclera / Q000473:pathology; D013997:Time Factors; D014728:Veterans; D014792:Visual Acuity; D014857:Warfare
chemical_list: D009151:Mustard Gas