B1. Corneal Degeneration & Dystrophy Flashcards
what is the difference between dystrophy and degeneration?
dystrophy: A disorder in which an organ or tissue of the body wastes away/weaken
Hereditary condition
NOT due to arrested development
Usually bilateral, only involves central acornea and retina
young onset
no vascularisation
degeneration:
Acquired loss of function associated with
Ageing
Inflammation
Infection
Vascular disease
Vitamin deficiency
Can be any part of the eye, often unilateral
40 or more years old
common vascularisation
what are the SSX of band keratopathy? is it a degeneration or a dystrophy? Mx?
degeneration
Symptoms:
Decreased vision (if blocking pupil)
Irritation, pain, FB sensation
Signs:
Early: white granular crescent at limbus
Later: spread centrally to form a band of chalky plaque
what are the SSX of crocodile shagreen? is it a degeneration or a dystrophy? any MX?
degeneration
Symptoms:
Asymptomatic
Signs:
Greyish-white polygonal opacities in stroma with clear spaces in between
no Mx
MX for band keratopathy?
Lubrication for mild sx
Chelation
Monitor 3-6 mths
background and cause for band keratopathy?
Background
Deposition of calcium in Bowman’s membrane
Due to:
Chronic anterior uveitis
Age-related
Systemic hypercalcemia
Hereditary
what are the 7 corneal dystrophies? classify the further by which layers of the cornea they affect
Epithelial basement membrane dystrophy (EBMD)
Meesman dystrophy (epithelial)
Reis-Buckler’s dystrophy (bowmans layer)
Granular dystrophy (stromal)
Lattice dystrophy (stromal)
Macular dystrophy (stromal)
Fuch’s dystrophy (endothelial)
what is the background and etiology of EBMD?
Background
Seen in 20-30yo, 10% of px recurrent erosions in 30’s
Etiology
Thickening of basement membrane into epithelium with protein deposits -> weak epithelial adhesion -> epithelial erosion
SSx of EBMD?
Signs:
Dot-like opacities
Microcysts
Maps
Fingerprints
Symptoms:
May range from no symptoms to irritation, photophobia, reduced VA
Mx for EBMD?
Management
Lubricants
Bandage CL
Topical hypertonic saline (5% NaCl)
what is the background of meesman dystrophy?
Background
Juvenile epithelial dystrophy
Presents before 2nd birthday
SSx of meesman dystrophy?
Signs
Small whitish intraepithelial cysts
Possible epithelial erosions
Symptoms
May range from no symptoms to irritation, photophobia, reduced VA (Same as EBMD)
Mx of meesman dystrophy?
Symptomatic relief, lubricants.
what is the background of reis-bucklers dystrophy?
Background
Onset is in early infancy
Autosomal dominant
SSx of reis bucklers dystrophy?
Hazy white, round, polygonal opacity in Bowman’s, progress to reticular pattern
Severe recurrent corneal erosions in childhood
Mx for reis bucklers dystrophy?
Excimer laser keratectomy
Lamellar keratoplasty