Disease of Cornea

Herbert pits #Y

Corneal pannus

Arcus Senilis

Pathology/Cause: It is caused by lipid (fat) deposits deep in the edge of the cornea. This condition is common in older adults and is generally considered a normal part of aging. It does not typically affect vision or require

If juvenile suspected hyperlipidemia

Band shaped keratopathy

Horizontal opacity

Pathology/Cause: Hyaline degeneration + Ca deposition

Keratoconus

Cornea/name condition:

Keratoconus

Pathology: progressive stromal thinning, leading to conical protrusion of the cornea

Refractive error type: associated with irregular astigmatism + irregular myopia

Characteristic sign: Munson’s sign

Treatment:

if early: cross-linking (to stop progression) + correction of astigmatism / glasses
if late/advanced stage: keratoplasty (KP) or corneal transplant

Hard contact lens

Infective keratitis

1- Hypopyon ulcer:
Causative organism: Pneumococci
What is hypopyon: Pus in the anterior chamber
Is it sterile? Yes
When does it become infected? After perforation

2- Herpetic ulcer:
Signs: Dendritic Herpes Cause: Herpes simplex or zoster virus
Complication: Loss of corneal sensation is common presentation if you use corticosteroid it will lead to? Geographic ( Amoeboid ) ulcer

3- Fungal:
Landmark: Microabscesses (satellite appearance)
Cause: Older patients, immunocompromised, ocular trauma from organic materials such as plant matter
Treatment: Usual treatment, Topical/systemic antifungals, Surgical Treatment (PKP)

4- Acanthamoeba keratitis:
Sign: Ring-shaped ulcer/keratitis

Treatment: Corticosteroid

Corneal transplant

Corneal transplant: Sutures placed all around the cornea (7- and 8-point appearance or straight interrupted)

Donor tissue coming from what: A deceased person (cadaveric)

Indications: Any corneal condition affecting vision or the visual axis;

e.g., Advanced keratoconus,
Keratomalacia
Fuchs’ endothelial dystrophy,
corneal scarring,
bullous keratopathy.

Keratoplasty

Corneal Foreign Body

Removal by: Slit-lamp-guided removal with a sterile needle or spud under topical anesthesia.

Never remove foreign body from eye in emergency room, only in operating room in sterile conditions

Chemical reactions

Siderosis: FE rust Chaliosis: CU

Alkaline is worst - results in rapid penetration of ocular tissue Acidic = coagulation of protein

Irrigate eye with normal saline at least 15 minutes In chemical burn then refer do not cover and refer to ophth

Corneal Trauma

Treatment:

Cover and refer to an ophthalmologist
Suture and repair according to the duration of iris prolapse

Investigations:

X-ray
CT
Ultrasound
Never use MRI

PRK: (corneal epithelium removal; by alcohol specific concentration, special spatula, after removal of epithelium wash the stroma by saline and then apply laser; Exciemer laser = ablation i.e. reshaping of corneal stroma