Diseases of Cornea
Diseases of Cornea
Diseases of Cornea
Transparencies
Corneal oedema
Drying of cornea
Depositions on cornea
Inflammation of cornea
Corneal degenerations
Dystrophies of cornea
Vascularisation of cornea
Corneal opacities
Corneal Diseases
Keratitis
Corneal ulceration
Corneal Scarring
Corneal Opacification
Corneal opacity
Slight opacification allowing the details of iris
to be seen thr. Opacity is called nebula/
nebular c.o.
More dense thr. Which iris & puppilary margin
are visible. (no details) called macula /
macular c.o.
If very dense, white & totally opaque
obscuring the view of iris & pupil is called
leucoma /leucomatous c.o.
Corneal opacity
Old central leucoma – sometimes show
horizontal pigmented line i.e. b/o deposition
of iron from precorneal tear film.
Adherant leucoma
Corneoiridic scar
If ectatic ant. Staphyloma
Vn.
Corneal oedema
Hydration of cornea becomes above 78%
central thickness increases & transperency
Reduces.
Causes –raised i.o.p.
endothelial damage- b/o surgery,
Secondary inflammation like uveitis, dystrophies
epithelial damage- mechanical injury,
Chemical injury ,radiational injury
Corneal oedema
Can affect entire cornea.
Epithelium- steamy appearance.
Stroma- haziness thr.out cornea.
If persists for long period epithelium tends to
be raised into large vesicle or bullae i.e.
vesicular or bullous keratopathy intense
pain & ocular irritation.
S.K.- delicate grey lines.
Corneal diseases
Filamentary keratopathy- formation of
epithelial threads /corneal filaments.
Keratic precipitates- deposition of
leucocytes & other cells on back the of
Cornea.
Hypopyon- polymorphonuclear leucocytes
which accumulates in angle of a.c.
Examination of cornea
External exam.-Torch, Slit-lamp
Surface irregularities- Placidos disc
Curvature-keratometry, corneal topography
Thickness-optical pachymeter, ultrasonic
pachymeter, slit scanning topography.
Endothelium- with slit lamp, cell counting
with microscope.
Source of infection
3. Stage of regression.
4. Stage of cicatrization.
Symptoms of corneal ulcer
1. Pain
4. Blurred vision
5. Redness of eyes
Signs of corneal ulcer
Lids are swollen
Marked blepharospasm
Conjunctivociliary congestion with chemosis
Keratouveitis
Hypopyon
Ulcer stained by fluroscein
Corneal ulcer
Complications of
corneal ulcer
1. Toxic iridocyclitis
2. Secondary glaucoma
3. Descemetocele
4. Perforation of corneal ulcer-
prolapse of iris
ant. Capsular cataract
corneal fistula
purulent uveitis
Subluxation / ant. Dislocation of lens
intraocular hemorrhage
5. Corneal scarring / opacity
Management of corneal ulcer
1.Clinical evaluation-
History kaking,
Regurgitation test
Slit lampBimicroscopic exam.-.
fluorescein dye test -
2. Laboratory investigations- routine & microbiological
3. Treatment
Treatment of uncomplicated
corneal
ulcer
1.Specific t/t-
Topical antibiotic
Systemic antibiotic
2. Non specific t/t-
Cycloplegic drugs
Systemic analgesic anti-inflammatory
Vitamins