cornea class 6
TRANSCRIPT
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CORNEA
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CORNEAL DYSTROPHIES &DEGENERATIONS
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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.
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CORNEAL DEGENERATION
These are non hereditary Usually unilateral condition May be associated with systemic disease
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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
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KERATOCONUS
Thinning Bulges
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KERATOCONUS
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KERATOCONUS Present with “defective vision” does not
improve despite full correction with glasses
Irregular astigmatism
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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
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KERATOCONUS Munsons sign
Retinoscopy yawning/ scissoring reflex
Distant direct ophthalmoscopy- oil droplet reflex
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Complication Acute hydrops:- sudden development of
corneal oedema, defective vision, pain, photophobia, lacrimation
Rupture of descemet’s membrane
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ACUTE HYDROPS
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Association
OcularVernal Catarrh Ectopia lentis Cong cataract AniridiaRetinitis pigmentosa
Systemic Marfan’s syndrome Atopy Down’s syndrome
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KeratoconusInvestigationsKeratometryCorneal topographyTreatment Contact lens Penetrating keratoplasty
Intracorneal rings Collagen cross linking
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KERATOGLOBUS
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KERATOGLOBUS Hereditary, bilateral & congenital
disorder Thinning & hemispherical protrusion
of cornea
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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
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Corneal dystrophies
C] Posterior dystrophies 1.Cornea guttata 2.Fuchs` endothelial dystrophy 3.Posterior polymorphous dystrophy 4.Congenital hereditary endothelial dystrophy
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Corneal dystrophiesANTERIOR DYSTROPHIES
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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
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Corneal dystrophiesSTROMAL DYSTROPHIES
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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
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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
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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
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Vogt’swhite limbal girdle
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Band Keratopathy Deposition of calcium
salt in Bowman’s membrane, sup. Part of stroma,& deep layer of epithelium
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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
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Band Keratopathy Treatment:- A] Chemical removal of calcium salts - EDTAB] Phototherapeutic keratectomyC] Keratoplasty