Corneal Degenerations Flashcards
a process in which normal elements of a tissue are transformed is termed what
degeneration
degeneration is associated with what
aging of tissues
degeneration can result from what
metabolic diseases
are degenerations benign or detrimental to normal function
can be either one
which degeneration is caused by vacuoles within corneal stroma & irregular alignment of stromal lamellae
Crocodile Shagreen
this clinical finding is indicative of which degeneration:
- grayish-white polygonal stromal opacities separated by clear space
- often involves anterior 2/3 of stroma
- can involve posterior 1/3 of stroma
Crocodile Shagreen
what symptoms do pts with Crocodile Shagreen have
asymptomatic
what is the most common peripheral corneal opacity
Arcus Senilis
what age population does Arcus Senilis occur in & are there any predisposing factors
- occurs in elderly pts w/ no predisposing systemic pt.
if Arcus Senilis is seen in a pt under 40, what does this mean & what should be done
may be associated w/ dyslipidemia → order lipid panel
these signs are indicative of which degeneration:
- stromal lipid deposition that typically starts in superior & inferior perilimbal corrnea & progresses circumferentially
- separated from limbus by a clear zone
Arcus Senilis
if Arcus Senilis is very dense, what appearance can it give
“blue eye” appearance
these clinical findings are indicative of which degeneration:
- whitish crescentic perilimbal bands at 9 &/or 3 o’clock
- can have “swiss cheese” hole pattern
- can have a clear interval between girdle & limbus
Limbal Girdle of Vogt
which type of Limbal Girdle of Vogt may be an early form of band keratopathy
type I
which type of Limbal Girdle of Vogt is more common
type II
which type of Limbal Girdle of Vogt is caused by subepithelial degeneration & calcium deposits
type I
which type of Limbal Girdle of Vogt is caused by degeneration of subepithelial collagen
type II
which degeneration is caused by an accelerated calcium salt deposits in Bowman’s, epithelial basement membrane, & anterior stroma
band keratopathy
these clinical findings are indicative of which degeneration:
- interpalpebral
- initially gray deposits → can become chalky-white as it progresses
- often begins at 3 & 9 o’clock, then spreads horizontally
- sharply demarcated edge separated from limbus by clear zone
band keratopathy
these ocular manifestations can cause which degeneration:
- chronic low-grade anterior uveitis (especially in juvenile rheumatoid arthritis)
- phthisis bulbi
- chronic stromal edema
- silicone oil in anterior chamber
band keratopathy
what are other causes of band keratopathy besides ocular manifestations
- age-related
- metabolic disorder
these metabolic conditions can cause which degeneration:
- hypercalcemia due to hyperparathyroidism
- vitamin D toxicity
- sarcoidosis
- renal failure
band keratopathy
what can band keratopathy result in
- ocular irritation
- irregular astigmatism
- decreased VA
how can you manage ocular irritation in band keratopathy
topical lubricants
how can you manage irregular astigmatism in band keratopathy if visual axis is clear
RGP CLs
what is the more common treatment for band keratopathy
chelation
these treatments are for which degeneration:
- chelation
- diamond burr
- laser phototherapeutic keratectomy
- lamellar keratoplasty
band keratopathy
what degeneration is histologically similar to pinguecula
pterygium
how is a pterygium different from a pinguecula
pterygium invades Bowman’s layer
pinguecula does not involve the cornea
what degeneration is caused by elastotic degeneration of vascularized subepithelial stromal collagen
pterygium
this clinical finding is indicative of which degneration:
- triangular fibrovascular subepithelial growth of degenerative bulbar conjunctival tissue over the limbus into the interpalpebral cornea
pterygium
pts who live in hot climates or have chronic UV exposure or have ocular surface dryness can develop which degeneration
pterygium
these symptoms are indicative of which degeneration:
- small lesions are asymptomatic
- can cause dellen at advancing edge
- decreased vision from induced astigmatism & obscuration of visual axis
- acute pain if inflamed
pterygium
these signs are indicative of which degeneration:
- fibrovascular corneal lesion
- linear epithelial iron depositions: Stocker’s line
pterygium
how can you treat a pterygium
ocular lubricants & UV protection
how do you treat a severe pterygium
excisional surgery (but can recur after)
what is a rare, non-inflammatory, slowly progressive & usually bilateral degeneration that occurs most commonly in middle-aged women
Salzmann nodular degeneration
this clinical finding is indicative of which degeneration:
- opacities progress to elevated whitish or blue-gray nodular lesions that can lead to epithelial thinning & stromal scarring
Salzmann nodular degeneration
which degeneration can occur in any form of chronic corneal irritation or inflammation such as:
- dry eye
- chronic blepharitis
- chronic allergic conjunctivitis
Salzmann nodular degeneration
these symptoms are indicative of which degeneration:
- gradual, painless vision loss
- foreign body sensation
- induced hyperopia & irregular astigmatism
Salzmann nodular degeneration
how do you treat Salzmann nodular degeneration & what do you do in severe cases
- manage underlying etiology
- topical lubricants
- surgical intervention if severe
which degeneration is an uncommon idiopathic thinning of the peripheral corneal stroma that occurs in men a lot more than women
Terrien’s marginal degeneration
these clinical findings are indicative of which degeneration:
- thinning starts superiorly → circumferentially with lipid deposits at leading edge
- marginal opacification w/ superficial vascularization
- irregular astigmatism develops as disease progresses
Terrien’s marginal degeneration
will Terrien’s marginal degeneration stain with NaFl & why
no, epithelium is intact
how can you manage pts w/ Terrien’s marginal degeneration in regards to significant thinning
polycarbonate safety lenses
how can you manage the irregular astigmatism in pts w/ Terrien’s marginal degeneration
CLs
in more advanced cases of Terrien’s marginal degeneration, how would you treat them
surgery
how can you differentiate Terrien’s marginal degeneration with arcus senilis
arcus senilis has no stromal thinning
how can you differentiate Terrien’s marginal degeneration with Mooren’s ulcer
Mooren’s ulcer will have significant pain & photophobia
how can you differentiate Terrien’s marginal degeneration with marginal keratitis
marginal keratitis will have significant symptoms
how can you differentiate Terrien’s marginal degeneration with pellucid marginal degeneration
pellucid marginal degeneration occurs inferiorly
