Unit 2 - corneal keratopathies part 2 Flashcards
What are the symptoms of lattice degeneration?
REES.
What deposits occur in granular dystrophy and where?
hyaline (means glass like material in sand i.e. grains) in stroma
What do the deposits in granular dystrophy look like?
white crumb-like opacities in an otherwise clear stroma, starts centrally
How does granular dystrophy present?
REES, recurrences are common
What deposits occur in avellino dystrophy?
both hyaline and amyloid (I’ll ‘ave both)
What is the clinical appearance in avellino dystrophy?
crumb and fibre like opacities
What treatment is required in avellino dystrophy?
None
What is different about macular dystrophy?
It is AR not AD
What deposits do you get in macular dystrophy?
glycosaminoglycan deposits
What do the deposits look like in macular dystrophy?
Ill defined grey/whitish lesions in stroma. Corneal haziness around lesions. Could involve full-thickness of stroma but usually anterior and central.
What are the symptoms of macular corneal dystrophy?
Sensation is reduced, gradual reduction in vision
What is the treatment of macular dystrophy?
PK or lamellar keratoplasty, recurrence is rare
What is deposited in Schnyder’s crystalline dystrophy?
Phospholipid and cholesterol deposits
How may Schnyder’s dystrophy present?
Prominent arcus and diffuse haze in childhood
What systemic checks need to be made with Schnyder’s dystrophy?
Fasting lipids
What are the symptoms of Fuch’s
vision worse in the morning
What is the incidence of Fuch’s in female:men?
4:1
What is the pathology in Fuch’s?
the endothelial tight junctions don’t work very well leading to corneal oedema
What is the treatment of Fuch’s?
DSAEK or DMEK, hypertonic saline, BCL, lubricants, topical ABX, cycloplegia
What other ocular associations are there with Fuch’s?
POAG
What ocular associates are there with Posterior polymorphous corneal dystrophy?
Iris abnormalities, glaucoma and alport syndrome
What is the appearance of Posterior polymorphous dystrophy?
cluster or lines of haze in posterior cornea
What is the difference between type 1 and 2 congenital endothelial corneal dystrophy?
Type 1 is AD (mild corneal odemea from infancy, patient is photophobic), Type 2 is AR (more common, more severe and associated with deafness and nystagmus)
What treatment is required in posterior polymorphouse corneal dystrophy?
Usually asymptomatic so no treatment
