Osler’s Sign-The Hidden Clue

Abstract

A 55-year-old male patient presented to the ophthalmology department for routine ocular examination. There was no ocular complaint nor there was a history of any previous ophthalmic consultation. The patient gave a history of having chronic back ache with pains in both his knees and was receiving non-steroidal antiinflammatory drugs from some other institute. There was no other significant medical, surgical, family, traumatic or drug abuse history.Ocular examination was carried out and his visual acuity was 6/6 in both the eyes; pupillary reactions, ocular movements, colour vision, fundus and intraocular pressure were normal bilaterally. Slit lamp and torch examination revealed bluish-black dots on the cornea, conjuctiva and sclera in the interpalpebral area bilaterally close to the medial and lateral rectus muscles (Figure 1). Dilated conjunctival vessels were seen to be supplying the pigmented areas. There were also pigmentary changes seen on his hands (Figure 2).