Upload
kiranchandranrox
View
1.789
Download
1
Embed Size (px)
Citation preview
CORNEA
CORNEAL DYSTROPHIES &DEGENERATIONS
Corneal dystrophies Corneal dystrophies are progressive
hereditary corneal disorder. It is bilaterally symmetrical Non vascularized Shows no signs of inflammation and are
without associated systemic disease.
CORNEAL DEGENERATION
These are non hereditary Usually unilateral condition May be associated with systemic disease
KERATOCONUS Defn- noninflammatory bilateral{85%}
ectatic condition of cornea in its axial part due to defective synthesis of mucopolysaccharide & collagen tissue
Starts at puberty and progresses slowly
KERATOCONUS
Thinning Bulges
KERATOCONUS
KERATOCONUS Present with “defective vision” does not
improve despite full correction with glasses
Irregular astigmatism
KERATOCONUS Placido disc Keratometry depicts misalignment of
miresSlit lamp Thinning of central cornea Fleischer’s ring at the base of cone Folds in descements vogts striae
KERATOCONUS Munsons sign
Retinoscopy yawning/ scissoring reflex
Distant direct ophthalmoscopy- oil droplet reflex
Complication Acute hydrops:- sudden development of
corneal oedema, defective vision, pain, photophobia, lacrimation
Rupture of descemet’s membrane
ACUTE HYDROPS
Association
OcularVernal Catarrh Ectopia lentis Cong cataract AniridiaRetinitis pigmentosa
Systemic Marfan’s syndrome Atopy Down’s syndrome
KeratoconusInvestigationsKeratometryCorneal topographyTreatment Contact lens Penetrating keratoplasty
Intracorneal rings Collagen cross linking
KERATOGLOBUS
KERATOGLOBUS Hereditary, bilateral & congenital
disorder Thinning & hemispherical protrusion
of cornea
Corneal dystrophies CLASSIFICATION A] Anterior dystrophies 1.Epithelial basement membrane dystrophy 2.Reis Buckler dystrophy 3.Meesman`s dystrophy
Recurrent corneal erosion syndrome B] Stromal dystrophies 1.Granular dystrophies 2.Lattice dystrophy 3.Macular dystrophy 4.Crystalline dystrophy
Corneal dystrophies
C] Posterior dystrophies 1.Cornea guttata 2.Fuchs` endothelial dystrophy 3.Posterior polymorphous dystrophy 4.Congenital hereditary endothelial dystrophy
Corneal dystrophiesANTERIOR DYSTROPHIES
Corneal dystrophiesRecurrent corneal erosion syndrome
TREATMENT: patching with plain ointment for 1 to 2 days Hypertonic saline drops or ointment decreases attack of
erosion by reducing epithelial oedemaLubricant eyedrops
Corneal dystrophiesSTROMAL DYSTROPHIES
Corneal dystrophies2.Fuchs endothelial dystrophy -slowly progressive bilateral
condition affecting females more than males
-usually 5th and 7th decade of life
-primary open angle glaucoma is its common association
CORNEAL DEGENERATION
These are non hereditary & usually unilateral condition
Classification:-A] Age related degeneration:- Arcus senilis, Vogt’s white limbal girdle, Hassal-Henle
bodies, Mosaic degenerationB] Pathological degeneration:- Fatty degeneration, Amyloidosis, Calcific
degeneration, Salzmann’s degeneration, Furrow degeneration, Spheroid degeneration, Pellucid marginal degeneration, Terrien’s marginal degeneration
ARCUS SENILIS Annular lipid
infiltration of corneal periphery in
Age related, occurs bilaterally in elderly
Arcus juvenilis :- similar changes in young, may or may not be associated with hyperlipidaemia
Vogt’swhite limbal girdle
Band Keratopathy Deposition of calcium
salt in Bowman’s membrane, sup. Part of stroma,& deep layer of epithelium
Band Keratopathy Etiology: Association with hypercalcaemia, chronic uveitis,
phthisis bulbi, chronic glaucoma, chronic keratitisCf.:- Band shaped opacity begins at periphery centre Later stage –transparent clefts due to
cracks or tears in calcium plaques
Band Keratopathy Treatment:- A] Chemical removal of calcium salts - EDTAB] Phototherapeutic keratectomyC] Keratoplasty