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Thread: Corneal signs aids to diagnosis capsule

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    Default Corneal signs aids to diagnosis capsule

    Corneal signs aids to diagnosis capsule



    ✍️ epithelial signs
    ✍️ stromal signs
    ✍️ endothelial signs

    epithelial signs 

    ✍️ Punctate epithelial erosions

    ☝️ Multiple fine areas of epithelial loss

    ☝️ stain well with Flurescene and poorly with Lissamine Green

    ☝️ causes

    Superior

    • VKC
    • superior limbic keratitis
    • floppy eyelid syndrome
    • poor CL fit)

    Interpalpebral

    • KCS
    • UV exposure
    • corneal anaesthesia

    Inferior

    • MGD
    • exposure keratopathy
    • ectropion
    • poor blink
    • poor Bell’s phenomenon
    • rosacea
    • preservative toxicity

    ✍️ Corneal filaments

    ☝️ Mucus strands adherent to cornea, with mobile
    free tails

    ☝️stain poorly with F and well with LG

    ☝️ causes

    • KCS
    • recurrent erosion syndrome
    • corneal anaesthesia
    • exposure keratopathy
    • herpes zoster ophthalmicus (HZO)

    ✍️ Punctate epithelial keratitis

    ☝️Tiny white spots of epithelial and inflammatory cells

    ☝️ stain poorly with F and well with LG

    ☝️ causes

    • Viral keratitis (adenovirus, HSV, molluscum contagiosum)
    • Thygeson’s superficial punctate keratopathy

    ✍️ Epithelial Oedema

    ☝️ Loss of lustre + translucency

    ☝️ microvesicles and bullae

    ☝️ causes

    • high IOP
    • post-operative
    • CL overwear
    • aphakic or pseudophakic bullous keratopathy
    • Fuchs’ endothelial dystrophy
    • trauma
    • acute hydrops
    • herpetic keratitis
    • congenital corneal clouding



    Corneal signs aids diagnosis capsule attachment.php?attachmentid=3457&d=1512897719


    stromal signs 

    ✍️ Pannus

    ☝️ Subepithelial fibrovascular ingrowth

    ☝️ causes

    • Trachoma
    • tight CL
    • phlycten
    • herpetic keratitis
    • rosacea keratitis
    • chemical keratopathy
    • marginal keratitis
    • VKC
    • atopic keratoconjunctivitis
    • superior limbal keratoconjunctivitis

    ✍️ Stromal infiltrate

    ☝️ Focal opacification due to leucocyte aggregations

    ☝️causes

    • CL-related (sterile)
    • microbial colonization
    (bacteria, fungi, viruses, protozoa)

    ✍️ Stromal oedema

    ☝️ Thickened, grey opaque stroma

    ☝️ causes

    • Post-operative
    • keratoconus
    • Fuchs’ endothelial dystrophy,
    • herpetic disciform keratitis

    ✍️ Cornea farinata

    ☝️Deep stromal faint Flour-like opacities

    ☝️Idiopathic (innocuous)


    ✍️ Crocodile shagreen

    ☝️ Reticular polygonal network of stromal
    opacity

    ☝️Idiopathic (innocuous)

    Corneal signs aids diagnosis capsule attachment.php?s=9ab88b462aa19a5deb987d087f9d9446&attachmentid=3458&d=1512897797

    endothelium signs 

    ✍️ Descemet’s Folds

    ☝️ in intact DM

    ☝️ causes

    • Post-operative
    • low IOP
    • disciform keratitis
    • congenital syphilis

    ✍️ Descemet’s Breaks

    ☝️ DM breaks associated oedema of overlying
    stroma

    ☝️ causes

    • Birth trauma
    • keratoconus ( hydrops)
    • keratoglobus
    • infantile glaucoma (Haab’s striae)


    ✍️ guttata

    ☝️ Wart-like protuberances

    ☝️Peripheral:
    Hassall–Henle bodies (physiological in the elderly)

    ☝️Central: Fuchs’ endothelial dystrophy


    ✍️ Pigment

    ☝️ Dusting of pigment from iris

    ☝️ causes

    • Pigment dispersion syndrome (PDS)
    • post-operative
    • trauma


    ✍️ Keratic precipitates (KPs)

    ☝️ Aggregates of inflammatory cells on endothelium

    ☝️ causes

    Keratitis
    • disciform
    • microbial
    • marginal

     Anterior uveitis
    • idiopathic
    • HLA-B27
    • Fuchs’ heterochromic cyclitis
    • sarcoidosis, etc











    Attached Images  
    Last edited by Reda Gomah El Garia; 12-10-2017 at 09:24 AM.

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