This is a classic Bitot’s spot in a 29-year-old man that shrunk dramatically with vitamin A therapy. This is a reversible eye disorder characterized by superficial foamy patches, composed of epithelial debris (dead surface cells) and secretions, that develop on the exposed bulbar conjunctiva (white of the eye) as a manifestaion of advanced vitamin A deficiency due to malnutrition, alcoholism, old age Celiac or Crohn's diseases, pancreatic insufficiency, and sometimes, spots develop in response to chronic conjunctival inflammation. Treatment is pretty straight forward, vitamin A supplementation and β-Carotene.