Corneal drawings

CORNEAL DRAWINGSCORNEAL DRAWINGS

HistoryHistory

• Schepens (1969): Retinal drawing

• “A simple scheme for documenting corneal disease”

Bron AJ. Br J Ophthalmol 1973, 57:629

• Systematic method of drawing corneal pathologyWaring GO 3rd, Laibson PR. Arch Ophthalmol 1977,95:1540

• Schepens (1969): Retinal drawing

• “A simple scheme for documenting corneal disease”

Bron AJ. Br J Ophthalmol 1973, 57:629

• Systematic method of drawing corneal pathologyWaring GO 3rd, Laibson PR. Arch Ophthalmol 1977,95:1540

Why draw?Why draw?• Standardization of documentation

• Easy follow-up

• Teaching

• Cheaper

• color pencils: erasable

Red,Blue,Green,Yellow,Black,Brown Observation power & S/L skills

• Drawing v/s photo: cost, area of interest

• Standardization of documentation

• Easy follow-up

• Teaching

• Cheaper

• color pencils: erasable

Red,Blue,Green,Yellow,Black,Brown Observation power & S/L skills

• Drawing v/s photo: cost, area of interest

BLACKBLACK

How to draw? Color codesHow to draw? Color codes

• Scar• Degeneration / deposits / guttatae• Sutures• CL (broken line) i.e contact lens• FB i.e foreign body • Tissue adhesive• Corneal nerves / Vogt’s striae• IOL– show only in corneal slit

• Scar• Degeneration / deposits / guttatae• Sutures• CL (broken line) i.e contact lens• FB i.e foreign body • Tissue adhesive• Corneal nerves / Vogt’s striae• IOL– show only in corneal slit

BLUEBLUE

• Epithelial edema

• Epithelial bullae

• Stromal edema

• DM(descemet membrane) folds

• Epithelial edema

• Epithelial bullae

• Stromal edema

• DM(descemet membrane) folds

How to draw? Color codesHow to draw? Color codes

YELLOWYELLOW

• Infiltrate

• Hypopyon

• KPs

• Lens (cataract)

• Infiltrate

• Hypopyon

• KPs

• Lens (cataract)

How to draw? Color codesHow to draw? Color codes

GREENGREEN

• Epithelial defect

• Fluorescein stain

• SPKs

• Filaments

• Vitreous

• Epithelial defect

• Fluorescein stain

• SPKs

• Filaments

• Vitreous

How to draw? Color codesHow to draw? Color codes

REDRED

• Blood vessels

Superficial

Deep

Ghost

• Hyphema

• Filaments

• Rose bengal

• Blood vessels

Superficial

Deep

Ghost

• Hyphema

• Filaments

• Rose bengal

How to draw? Color codesHow to draw? Color codes

BROWNBROWN

• Pigments

(Iron lines, epi. melanosis, Kruckenberg’sspindle )

• Iris

• Pupil

• PAS i.e peripheral anterior synaechia

• Pigments

(Iron lines, epi. melanosis, Kruckenberg’sspindle )

• Iris

• Pupil

• PAS i.e peripheral anterior synaechia

How to draw? Color codesHow to draw? Color codes

Frontal view

Slit view

Vital stains

Frontal view

Slit view

Vital stains

How to draw? How to draw?

• Circle (35 mm?)

• Pupil

• Outline opacities: “Sclerotic scatter”

• Scar v/s infiltrate v/s edema:

Scar: Grey-white, reflectance, ↓ thickness, “Zebra pattern”

Infiltrate: Yellowish, diffuse slit, cellular

Edema: Ground glass, thickness of slit

• Circle (35 mm?)

• Pupil

• Outline opacities: “Sclerotic scatter”

• Scar v/s infiltrate v/s edema:

Scar: Grey-white, reflectance, ↓ thickness, “Zebra pattern”

Infiltrate: Yellowish, diffuse slit, cellular

Edema: Ground glass, thickness of slit

How to draw? How to draw?

• Add vessels, pigments, folds etc.

• Fine details: Go quadrant wise

• Sutures

• BCL, tissue adhesive

• Draw separately lens & AV (If needed)

• No details other then on the cornea:NO hypopyon/hyphema, AC exudates, FB in AC

• Add vessels, pigments, folds etc.

• Fine details: Go quadrant wise

• Sutures

• BCL, tissue adhesive

• Draw separately lens & AV (If needed)

• No details other then on the cornea:NO hypopyon/hyphema, AC exudates, FB in AC

How to draw? How to draw?

• Depict the site of slit on the frontal view

• Dotted posterior line: post surface not visible

• Stromal thickness: bow behind

• Area of thinning: mention %

• Descemetocele

• AC depth and lesions in AC

• Lens, vitreous, IOL

• Depict the site of slit on the frontal view

• Dotted posterior line: post surface not visible

• Stromal thickness: bow behind

• Area of thinning: mention %

• Descemetocele

• AC depth and lesions in AC

• Lens, vitreous, IOL

How to draw? How to draw?

• Last to be done

• SPKs: “Remember, numbers are imp.”

• “Separate diagram if needed”

• Last to be done

• SPKs: “Remember, numbers are imp.”

• “Separate diagram if needed”

How to draw? How to draw?

• Slit lamp:

• Slit height

• Graticule

• Coaxial illumination, narrow slit

• “Mention shape of lesion”

• Mention landmark of measurement

• Ulcer: max. diameter, mark it with arrows

• Slit lamp:

• Slit height

• Graticule

• Coaxial illumination, narrow slit

• “Mention shape of lesion”

• Mention landmark of measurement

• Ulcer: max. diameter, mark it with arrows

How to draw? How to draw?

Important pearlImportant pearl

FOLLOW THE CLOCK HOUR RULE FOR

PERFECT DRAWING

FOLLOW THE CLOCK HOUR RULE FOR

PERFECT DRAWING

Happy Drawing!!Happy Drawing!!