Corneal Degenerations

Question 1

Patient works outside alot. On SLE you find irregular protein deposits in the anterior stroma replacing Bowman’s Layer. This finding is bilateral. What is it?

Answer 1

Spheroidal degeneration

Question 2

Presentation: Golden brown, oily droplets under the epithelium of conj. Found at 3 and 9 oclock.

Answer 2

Spheroidal degeneration

Question 3

Pt presents with a corneal opacity typically located where a metallic foreign body was. The deposit contains iron. What is it? How do you treat it?

Answer 3

Coat’s White Ring

No tx indicated, but use algae brush in attempt to clear it up one time

Question 4

Presentation: Small, granular, white oval ring

Answer 4

Coat’s white ring

Question 5

Pt presents with a bluish-white nodule in a circular fashion around midperipheral cornea. These deposits are surrounded by iron from the tears. What is it?

Answer 5

Salzmann’s degeneration

Question 6

What is the etiology of Salzmann’s degeneration?

Answer 6

• Related to chronic inflammation

- From virus, old phlyctenule or trachoma

Question 7

Pt presents w/ calcium salt deposits in the interpalpebral fissue area of bowman’s membrane, found at 3-9pm. Looks like a swiss cheese appearance. WIT?

Answer 7

Band keratopathy

Question 8

What is the etiology of band keratopathy?

Answer 8

• ocular inflammation

- hypercalcemia

Question 9

Band keratopathy is more common in what ocular issue?

Answer 9

• Phthisis bulbi

Question 10

How do you treat band keratopathy?

Answer 10

Scrape calcium from epithelium

Question 11

Pt presents with dense yellow-white opacities in the cornea, found near areas of neo. Pt just had HSV/HZV a few weeks ago.. WIT?

Answer 11

Lipid degeneration

Question 12

What is the etiology of lipid degeneration?

Answer 12

Can be primary or secondary due to trauma or corneal disease

Question 13

40 yo male pt presents with yellow-white punctate stromal oppacities which start superior and spread. You notice marginal thinning w/ a peripheral gutter. You though t it was arcus, but he’s too young. WIT?

Answer 13

Terrien’s Marginal Degeneration

Question 14

What is the etiology of Terrien’s Marginal degeneration?

Answer 14

Idiopathic
Rare
Bilateral

Question 15

What’s our biggest concern in terrien’s marginal degeneration?

Answer 15

Corneal perforation

Question 16

What type of astigmatism is found in Terrien’s Marginal Degeneration?

Answer 16

ATR astigmatism

Question 17

Pt presents with severe pain, photophobia and blur due to increased astigmatism. On SLE you find a marginal stromal ulceration affecting 1/3 of cornea, looks infiltrated. WIT?

Answer 17

Mooren’s Ulcer

Question 18

In a mooren’s ulcer, who gets it bilaterally and unilaterally? which is worse?

Answer 18

Old = unilateral
Young = bilateral, worse

Question 19

Elderly pt presents with thined cornea in the area of arcus. No perforation or neo. WIT?

Answer 19

Furrow degeneration

Question 20

What systemic diseases is Furrow degeneration associated with?

Answer 20

RA
SLE
Polyarteritis Nodosa

Question 21

Pt presents with bilateral white, irregular chalky flecks in the nasal and temporal cornea and medial limbal areas of Bowman’s. No neo was found and vision is unaffected. WIT?

Answer 21

Limbal Girdle of Vogt

Question 22

Limble girdle of Vogt is found in what age group?

Answer 22

Any age, but more common over 45

Question 23

Pt presents with bilateral polygonal, grayish-white stromal opacities separated by clear tissue. SLE reveals it’s located in the epithelium, bowmans, and anterior 2/3 or stroma. VA not affected.

Answer 23

Anterior Crocodile Shagreen

Question 24

What layers is posterior crocodile shagreen found?

Answer 24

Deep stroma an descemet’s layer

Question 25

Pt presents w/ bilateral flour dust appearance of deep stroma. You think it might be PEE/PEK. SLE shows small grey-white dots deep in the stroma or predescemet’s zone. WIT?

Answer 25

Cornea Farinata

Question 26

Pt presents with yellowish brown horizontal line of pigment between lower pupil margin and inferior limbus. WIT?

Answer 26

Hudson Stahli Line

Question 27

Pt presents with localized thinning in areas of cornea due to tear film instability and dryness. WIT?

Answer 27

Dellen

Question 28

What is the etiology of Dellen?

Answer 28

Thinning of the cornea or sclera due to water loss from corneal stroma or sclera.