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Corneal Dystrophies (and Keratoconus) > Signs, Symptoms, and Tx > Flashcards

Signs, Symptoms, and Tx Flashcards

1
Q

What is the Tx for corneal hydrops?

A

Cycloplegic (cyclopentolate 1%) Bacitracin ointment q.i.d. Consider brimonidine 0.1% b.i.d. OR Sodium chloride 5% ointment b.i.d. until resolved

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2
Q

What is the typical follow up schedule for corneal hydrops?

A

1-4 weeks

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3
Q

Describe typical corneal dystrophy properties.

A

Bilateral Inherited (usually AD - Except macular dystrophy and type 3 lattice dystrophy Progressive Without inflammation No corneal neo

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4
Q

What are the 3 anterior corneal dystrophies?

A

EBMD (Map-dot-fingerprint) Meesmann Corneal dystrophy of Bowman’s layer Reis-Buckler (type 1); Thiel-Behnke (type 2)

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5
Q

Which is the most common anterior corneal dystrophy?

A

EBMD

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6
Q

When is Meesmann Dystrophy typically noted?

A

The first years of lief, but asymptomatic until middle age

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7
Q

What are the typical findings of EBMD?

A

Diffuse gray patches (maps) Creamy white cysts (dots) Fine refractile lines (fingerprints)

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8
Q

What symptoms are associated with EBMD?

A

Corneal erosions - like RCE Decreased VA Monocular diplopia Shadow images

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9
Q

What is the typical finding in Meesmann dystrophy?

A

Discrete, tiny epithelial vesicles diffusely involving the cornea, but concentrated in the palpebral fissure

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10
Q

What Tx is common in Meesmann?

A

None, but if severe photophobia or reduced VA occurs, bandage SCls or superficial keratectomy may be beneficial

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11
Q

Meesmann dystrophy is a dystrophy of which layer of the cornea?

A

Epithelium

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12
Q

Reis-Bucklers is a dystrophy of which corneal layer?

A

Bowman’s

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13
Q

When does Reis-Buckler typically appear?

A

Early in life

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14
Q

What are the typical findings in Reis-Buckler?

A

Subepithelial, gray reticular opacities in the central cornea

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15
Q

What are the common symptoms of Reis-Buckler?

A

Recurrent corneal erosions Reduced VA

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16
Q

What are the common Txs for Reis-Buckler?

A

Corneal transplantation surgery - but dystrophy may recur Excimer laser PTK or superficial lamellar keratectomy may work

17
Q

What are the 4 stromal dystrophies?

A

Lattice Granular Macular Schnyder

18
Q

What is the common Tx for stromal dystrophies that are causing reduced VA?

A

Corneal transplant or PTK

19
Q

Dx?

A

Reis Buckler Epithelial dystrophy

20
Q

Dx?

A

Reis Buckler Epithelial Dystrophy

21
Q

Dx?

A

EBMD

22
Q

Dx?

A

EBMD

23
Q

Dx?

A

EBMD

24
Q

Dx?

A

Meesmann Epithelial dystrophy

25
Q

Dx?

A

Meesmann Epithelial dystrophy

26
Q

Dx?

A

Meesmann Epithelial dystrophy

27
Q

Dx?

A

Lattice Stromal dystrophy

28
Q

Dx?

A

Lattice Stromal dystrophy

29
Q

How many clinical forms of Lattice Stromal dystrophy exist?

A

4

30
Q

What is the most common form of Lattice Stromal dystrophy?

A

Type 1 - Biber-Haab-Dimmer

31
Q

What are the common findins of type 1 Lattice Stromal dystrophy?

A

Refractile branching lines

White subepithelial dots

Scarrig of the central cornea (on retro)

32
Q

What is one of the common complaints with Lattice Stromal dystrophy?

A

RCE

33
Q

On which part of the cornea does Lattice Stromal dystrophy typically present?

A

Central - periphery is usually clear

34
Q

What is the Tx for RCE?

A

Acute: Cycloplegic (ex 1% cyclo) and ABx ointment (erythromycin or bacitracin 4-6x daily)

Post healing: ATs 4-8x daily for 3-6mo; or Muro128 4x daily for 3-6mo

35
Q

What is type 2 Lattice Stromal dystrophy associated with?

A

Systemic amyloidosis

Facial mask

Ear abnormalities

Cranial and peripheral nerve palsies

Dry and lax skin

36
Q

When is the typical onset of types 3 and 4 Lattice Stromal dystrophy?

A

5-7th decades

Corneal Dystrophies (and Keratoconus) (1 decks)

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