History A 54-year-old, lightly pigmented woman was noted to have a bluish discoloration of her sclera on routine examination by her optometrist. At presentation, the patient noted an asymptomatic, non-progressive, bluish discoloration of her sclerae for over 10 years. She had a 10-year history of tetracycline use (over 1825 grams total) followed by an additional 20 years of minocycline use (1460 grams total) for acne. She had discontinued minocycline 2 years prior to presentation.
Examination On examination, the patient’s visual acuity was 20/25 bilaterally. Her pupillary examination, intraocular pressures, extraocular movements, and confrontational visual fields were all normal. She had dark brown and blue discoloration of the sclera circumferentially approximately 4 mm posterior to the limbus bilaterally, most concentrated nasally and temporally (Figures 1 and 2). There was no scleral…
