Which ocular condition is MOST associated with hyperparathyroidism?

• A. PSC cataracts
• B. Bitot's spots
• C. Band keratopathy
• D. Fuch's endothelial dystrophy

Answer: (C)

Hyperparathyroidism raises calcium and phosphate levels in the blood, which can precipitate as calcium salts in the cornea, most characteristically in Bowman's layer. This calcium deposition produces band keratopathy, a horizontal, grayish-white band across the central cornea that can blur vision. The condition is a classic ocular sign linked to long-standing hypercalcemia and hyperphosphatemia, making it the option that best fits the systemic–ocular connection.

The other choices don’t share this strong link. Bitot’s spots arise from vitamin A deficiency and reflect conjunctival changes rather than calcium deposition. Posterior subcapsular cataracts are associated with factors like aging, steroid use, and diabetes, not hyperparathyroidism. Fuchs endothelial dystrophy involves endothelial cell loss and corneal edema, unrelated to calcium metabolism.