Eyelids and anterior segments: Case ten

This 65 year old man was a long-stay patient in a psychiatry hospital. He had been treated for schizophrenia since the age of 30. Recently, he complained of blurred vision in both eyes. Slit-lamp examination showed the above appearance.

a. What is seen in this picture?

b. What is the most likely cause in this patient?

c. What other ocular signs may occur in this patient?