Punctate epithelial erosions (PEE) are evidence of ocular surface dryness. They represent areas of epithelial cell loss and therefore stain positively with fluorescein. The distribution of the PEE can provide information regarding the underlying etiology. Inferior PEE, as seen in this photograph, can be secondary to exposure, chronic blepharitis, or trichiasis. This patient previously underwent multiple eyelid surgeries resulting in exposure keratopathy.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.