Corneal disorders

Question 1

Enlarged corneal nerves

Answer 1

NFLMAP

• NF
• Familial dysautonomia
• Leprosy
• MEN 2B
• Acanthamoeba
• Phytanic acid storage disorder (Refsums)

Question 2

Mikulicz’s syndrome

Answer 2

• lacrimal and parotid gland swelling
• keratoconjunctivitis sicca
• due to sarcoidosis, TB, lymphoma, leukemia

Question 3

Ocular cicatricial pemphigoid

Answer 3

Type II hypersensitivity

• no filaments
• assoc with HLA B12
• symblepharon, ankyloblepharon, trichiasis, entropion, subconjunctival fibrosis, dry eye, corneal ulcers, vascularization, scarring
• occurs at level of BM (subepi bullae)
• Tx: lubrication, dapsone, cyclophosphamide

Question 4

Interstitial keratitis

Answer 4

Syphilis, TB, HSV, MMR, sarcoid, Cogan’s syndrome, etc

Question 5

Thygeson’s SPK

Answer 5

• assoc with HLA-DR3
• gray-white snowflake opacities in corneal epithelium
• 90% bilateral
• Tx: topical steroids

Question 6

Filamentary keratitis

Answer 6

• due to increased mucus production and abnormal epithelial turnover
• Etiology: dry eye, SLK, recurrent erosions, bullous keratopathy, HSV, neurotrophic keratitis, trauma, atopic dermatitis, EKC, medicamentosa
• Tx: acetylcystine, lubrication, remove filaments, BCL, underlying disorder

Question 7

Salzmann’s nodular degeneration

Answer 7

• due to chronic inflammation
• replacement of Bowman’s membrane by hyaline and fibrillar material
• tx: superficial keratectomy, PTK

Question 8

Hassall-Henle bodies

Answer 8

• peripheral, wart-like excrescences of Descemet’s

- normal senescent change