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CORNEA ANOMALIES > CORNEAL DEGENERATIONS > Flashcards

CORNEAL DEGENERATIONS Flashcards

1
Q

what are corneal degenerations?

A
  • Gradual deterioration in the tissue of the cornea into a less functional form.
  • Non-hereditary conditions that occur secondary to aging, previous insult, or disease.
  • Show as unilateral, asymetrical & mainly affects the peripheral cornea & vessels (neovascular)
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2
Q

what are symptoms of corneal degenerations?

A
  • asymptomatic, but can have: pain, photophobia, epiphora, blurry vision.
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3
Q

what is Corneal arcus (arcus senilis)

A

Lipid deposition begins on Descemet’s membrane and Bowman’s layer before extending into the stroma.

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4
Q

what is arcus associated with?

A
  • Associated with aging and high cholesterol
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5
Q

signs of arcus?

A
  • appears as a white, hazy band in the superior & inferior margins of the cornea –> then extends 360 degrees around the peripheral cornea.
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6
Q

what to do if patient is less than 40 years old with arcus?

A

lipid panel is required

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7
Q

what is limbal girdle of Vogt?

A
  • Deposition composed of fine granular chalk-like flecks underneath the corneal epithelium.
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8
Q

signs of limbal girdle of Vogt?

A
  • Yellowish-white, chalky, arc-like band located 3 & 9 o’clock of the intrapalpebral limbus.
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9
Q

what is Crocodile shagreen?

A
  • Crocodile shagreen is characterized by bilateral greyish– white cracked ice/mosaic pattern in Bowman’s layer.
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10
Q

what is Cornea farinata?

A
  • Characterized by fine flour-like deposits (flour dust) in the central deep stroma
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11
Q

what is band keratopathy?

A
  • Band keratopathy consists of the age-related deposition of calcium salts or uric crystal in Bowmans layer, epithelial basement membrane and anterior stroma.
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12
Q

what systemic conditions can band keratopathy be associated with?

A
  • calcium salts = hypercalcemia
  • uric crystals = gout
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13
Q

signs of band keratopathy?

A
  • Peripheral interpalpebral calcification with gradual central spread to form a band-like chalky plaque containing transparent small holes that gives a “Swiss cheese” appearance
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14
Q

tx for band keratopathy?

A

aimed at removing calcium via:
* * Chelation via EDTA (dissolves calcium).
* superficial keratectomy
* phototherapeutic keratectomy (PTK)

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15
Q

what is Salzmann’s nodular?

A
  • Raised, blue/gray-white hyaline plaques (nodules) arranged in circular fashion around the corneal mid-periphery at the layer of Bowman’s membrane
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16
Q

what causes Salzmann’s nodular degeneration?

A
  • caused by chronic corneal inflammation (inflammatory disease)
17
Q

tx for salzmann’s nodular degeneration?

A

aimed at removing nodules via:
* superficial keratectomy
* phototherapeutic keratectomy (PTK)

18
Q

what is lipid keratopathy?

A
  • Fatty degeneration of the cornea characterized by whitish-yellowish deposits consisting of cholesterol & fatty acids.
19
Q

what are the 2 types of lipid keratopathy?

A
  • Primary – lipid degeneration occurs in the absence of corneal vascularization & serum lipid levels are normal.
  • Secondary – lipid degeneration occurs with corneal vascularization secondary to disease such as corneal infections (HSV/HZV), interstitial keratitis, ocular trauma, glaucoma, chronic iridocyclitis.
20
Q

tx for lipid keratopathy?

A

aimed at reducing inflammation via:
* argon laser photogoagulation
* Topical corticosteroids
* Needle point cautery
* PK

21
Q

what is Terrien marginal degeneration

A

painless, bilateral, slow progressive peripheral corneal thinning w/ fine superficial vascularization

22
Q

Terrien marginal degeneration occurs in what quadrant of the cornea?

A
  • superior cornea
23
Q

what kind of astigmatism can Terrien marginal degeneration lead to?

A

ATR

24
Q

who gets terrien marginal degeneration

A

men in their 30s

25
Q

tx for terrien marginal degeneration

A
  • inital – correction with glasses.
  • if unsuccessful – consider PK
26
Q

tx for arcus, crocodille shagreen, limbal vogt, an cornea farinata?

A

no tx

CORNEA ANOMALIES (6 decks)

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