Fig. 45. Bitot's spot. A. The clinical appearance (arrow). B. The conjunctival epithelium shows hyperkeratosis. Note the prominent granular layer (arrow). Pleomorphic gram-positive rods, compatible with diphtheroids, are clustered around the keratin debris (inset). (Courtesy of SEI Photoarchives.) (B, hematoxylin-eosin, ×200; inset, MacCallum-Goodpasture, ×400.) (Levine RA, Rabb MF: Bitot's spot overlying a pinguecula. Arch Ophthalmol 86:525, 1971.)