Signs, Symptoms, and Tx

Question 1

What is the Tx for corneal hydrops?

Answer 1

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

Question 2

What is the typical follow up schedule for corneal hydrops?

Answer 2

1-4 weeks

Question 3

Describe typical corneal dystrophy properties.

Answer 3

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

Question 4

What are the 3 anterior corneal dystrophies?

Answer 4

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

Question 5

Which is the most common anterior corneal dystrophy?

Answer 5

EBMD

Question 6

When is Meesmann Dystrophy typically noted?

Answer 6

The first years of lief, but asymptomatic until middle age

Question 7

What are the typical findings of EBMD?

Answer 7

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

Question 8

What symptoms are associated with EBMD?

Answer 8

Corneal erosions - like RCE Decreased VA Monocular diplopia Shadow images

Question 9

What is the typical finding in Meesmann dystrophy?

Answer 9

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

Question 10

What Tx is common in Meesmann?

Answer 10

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

Question 11

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

Answer 11

Epithelium

Question 12

Reis-Bucklers is a dystrophy of which corneal layer?

Answer 12

Bowman’s

Question 13

When does Reis-Buckler typically appear?

Answer 13

Early in life

Question 14

What are the typical findings in Reis-Buckler?

Answer 14

Subepithelial, gray reticular opacities in the central cornea

Question 15

What are the common symptoms of Reis-Buckler?

Answer 15

Recurrent corneal erosions Reduced VA

Question 16

What are the common Txs for Reis-Buckler?

Answer 16

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

Question 17

What are the 4 stromal dystrophies?

Answer 17

Lattice Granular Macular Schnyder

Question 18

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

Answer 18

Corneal transplant or PTK

Question 19

Dx?

Answer 19

Reis Buckler Epithelial dystrophy

Question 20

Dx?

Answer 20

Reis Buckler Epithelial Dystrophy

Question 21

Dx?

Answer 21

EBMD

Question 22

Dx?

Answer 22

EBMD

Question 23

Dx?

Answer 23

EBMD

Question 24

Dx?

Answer 24

Meesmann Epithelial dystrophy

Question 25

Dx?

Answer 25

Meesmann Epithelial dystrophy

Question 26

Dx?

Answer 26

Meesmann Epithelial dystrophy

Question 27

Dx?

Answer 27

Lattice Stromal dystrophy

Question 28

Dx?

Answer 28

Lattice Stromal dystrophy

Question 29

How many clinical forms of Lattice Stromal dystrophy exist?

Answer 29

4

Question 30

What is the most common form of Lattice Stromal dystrophy?

Answer 30

Type 1 - Biber-Haab-Dimmer

Question 31

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

Answer 31

Refractile branching lines White subepithelial dots Scarrig of the central cornea (on retro)

Question 32

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

Answer 32

RCE

Question 33

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

Answer 33

Central - periphery is usually clear

Question 34

What is the Tx for RCE?

Answer 34

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

Question 35

What is type 2 Lattice Stromal dystrophy associated with?

Answer 35

Systemic amyloidosis Facial mask Ear abnormalities Cranial and peripheral nerve palsies Dry and lax skin

Question 36

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

Answer 36

5-7th decades