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Ocular Disease I Part II > Corneal Degeneration and Ectasia > Flashcards

Corneal Degeneration and Ectasia Flashcards

1
Q

What is degeneration?

A

A process in which normal elements of corneal tissue are converted representing a change in tissue

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2
Q

Degeneration could be due to ______ and _______

A

Involution and metabolic disease

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3
Q

The change in tissue that occurs with degeneration could be _____ or _____

A

benign or detrimental to normal physiology

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4
Q

Describe the ongoing process in the photo

A

Epithelial Cell migration

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5
Q

What are the non sight threatening corneal degenerations?

A
  • Crocodile Shagreen (mosaic)
  • Arcus Senilis
  • Limbal Girdle of Vogt
  • Farinata
  • Terrien’s Marginal Degeneration
  • Mooren’s Ulcer
  • Amyloid
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6
Q

What are the sight threatening opacifying corneal degenerations?

A
  • Salzmann’s Nodular
  • Amyloid
  • Spheroidal
  • Band Keratopathy
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7
Q

What is the condition indicated in the photo?

A

Crocrodile Shagreen

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8
Q

What is the significance in the finding of arcus in a patient < 40yrs old?

A

The patient most likely has hyperlipidemia

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9
Q

What condition is presented in the photo?

A

Arcus

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10
Q

Describe the conditions portrayed in the pictures

A
  • Anterior crocrodile shagreen: at the level of Bowman’s layer
  • Posterior crocodile Shagreen: at the posterior corneal stroma & Descemet’s
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11
Q

How many types of Limbal Girdle of Vogt are there?

A

Two

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12
Q

Describe Type I Limbal Girdle of Vogt

A
  • Lucid interval – deposition ends at Bowman’s. Swiss cheese holes. Sharp edge centrally
  • Early form of band keratopathy
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13
Q

Describe Type II Limbal Girdle of Vogt

A

“True Vogt’s”
•To limbus – elastoid degeneration of subepithelial collagen. Extensions centrally

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14
Q

Describe the condition in the photo

A

Limbal Girdle of Vogt

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15
Q

ID the condition in the photo and specify which category

A

Type 1 Limbal Girdle of Vogt

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16
Q

ID what condition is in the picture and specify which category it is

A

Type 2 limbal Girdle of Vogt

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17
Q

What are farinata?

A

white dust-like particles
pre-Descemet’s
with aging

18
Q

Furrow Degeneration refers to ____

A

painless, noninflammatory peripheral corneal thinning, adjacent to corneal arcus that occur without vascularization

19
Q

Stocker’s line

A

Refers to the occasional line of iron deposition can be seen adjacent to the head of the pterygium

20
Q

Describe the boxed feature in the photo

A

Stocker’s line

21
Q

ID the highlighted feature in the photo

A

Hudson-Stahli line

22
Q

ID the features in the photo

A

Iron lines

23
Q

ID the condition in the photo

A

Terrien’s Marginal Degeneration

24
Q

ID the condition in the photo

A

Terrien’s Marginal Degeneration

25
Q

What is a differential diagnosis for Terrien’s Marginal Degeneration?

A

Mooren’s Ulcer

26
Q

Terrien’s Marginal Degeneration usually occurs in which geographic region?

A

Superior region

27
Q

Terrien’s is not a perforating disease. T/F

A

T

(Epithelium is intact)

28
Q

List some charax of Terrian’s Marginal Degeneration

A
  • bilateral
  • thinning of peripheral corneal stroma starts superior-nasal then circumferential
  • fine line of lipid deposit
  • marginal opacification with superficial vascularization
  • males >> females
  • any age and >40
29
Q

What conditions are indicated in the photos?

A

Vascularization and pseudo-pterygium due to Terrien’s

30
Q

Describe the condition in the picture and indicate its common charax

A

non-infectious, unknown etiololgy (most likely autoimmuned)

31
Q

what are the symptoms associated with Mooren’s

A

Photophobia, red eye, pain

32
Q

What are the signs of Mooren’s?

A
  • disrupted corneal epithelium near limbus
  • typically progressive (circumferentially and centrally)
  • thinning, stromal melting, potentially perforation
33
Q

what staining method is used to examine Mooren’s?

A

NaFl staining

34
Q

What are the types of Mooren’s?

A
  • Type I: typically seen in the older patient, unilateral, better response to treatment
  • Type II: younger (African descent) 20-30 yr old, bilateral, poor response to treatment
35
Q

How would you differentiate Mooren’s from Terrien’s?

A
  • Terrien’s epithelium intact, no NaFl stain (not true ulceration)
  • Terrien’s rarely painful, inflammatory
  • Terrien’s rarely aggressive
  • Terrien’s rarely move centrally
  • Terrien’s rarely perforates
36
Q

What is the systemic disease workup for Mooren’s?

A

•Mandatory referral for vasculitis or collagen vascular disease
Autoimmune disease

37
Q

What is the treatment for Mooren’s?

A

supportive treatment with topical steroids to control inflammation
•Conjunctival resection, radiation
•Bandage CL
•Topical cyclosproine or systemic immunosupression
•Perforation: tx with cyanoacrylate or lamellar keratoplasty

38
Q

ID the condition in the photo and indicate some of its charax

A

Polymorphic Amyloid Degeneration

Deep stromal, bilateral and similar to Lattice Dystrophy

39
Q

ID the condition in the photo

A

Spheroidal Degeneration

40
Q

ID the conditin in the photo

A

Salzmann’s Nodular degeneration

41
Q
A

Ocular Disease I Part II (2 decks)

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