Constellation-like linear keratic precipitates

A 64-year-old asymptomatic female presented a few years following cataract surgery for a routine follow-up. Visual acuity was 20/30 in both eyes. Slit-lamp examination of the left eye revealed small pigmented keratic precipitates (KPs) [Fig. 1a and b]. These were mostly scattered in the Arlt’s triangle, with a group arranged linearly in a constellation-like configuration, with no signs of active inflammation. Fundoscopy, fellow eye findings, and intraocular pressures were normal. The impression was of a previous subclinical anterior uveitis, possibly related to the cataract surgery. Herpesviruses or syphilis should be considered when KPs are linearly arranged.[1-3] This is particularly relevant in the context of penetrating or endothelial keratoplasty, in which linear KPs may be misdiagnosed as endothelial rejection, leading to inaccurate treatment.Figure 1: Slit-lamp photo of the anterior segment. (a) Low-magnification view of pigmented KPs. (b) High-magnification view of the group of linear KPs in a striking constellation-like arrangementDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: Nil.