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Anterior
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Medical
Professional
10/03/2008

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Term
AQUIRED CORNEAL DEGENERATIONS:
Definition
Amyloidosis , Spheroid, ,Coat’s White Ring, Salzmann’s Degeneration, Band Keratopathy, Terrien’s Marginal Degeneration
Term
SENILE CORNEAL DEGENERATIONS:
Definition
White Limbal Girdle of Vogt, Anterior Crocodile Shagreen, Posterior Crocodile Shagreen, Cornea Farinata, Arcus Senilis, Descement’s Hypertrophy
Term
Amyloidosis
Definition
is a disease of unknown etiology characterized by abnormal deposition of amyloid, a translucent homogeneous glycoprotein, in various organs and tissue of the body. In the eye it may occur as a primary infection , or chronic infections, affecting any ocular structure. In the cornea the lesions consist of pink to yellow central raised fleshy masses with a nodular surface and the cornea may become vascularized. ** 6.21
Term
Spheroid
Definition
it consist of yellow, oil droplets under the epithelium of the cornea, most often found at the 3 and 9 o’clock meridian, secreted by abnormal fibrocytes. Primary disease are bilateral and located in the superficial stroma, while Secondary types are unilateral and epithelial.
Term
Coat’s White Ring
Definition
This is small corneal opacity which is usually located in an area where there previously was a foreign body. It appears as a granular oval ring that is white and contains iron deposits.
Term
Salzmann’s Nodular Degeneration
Definition
This consist of a bluish, raised, non-inflammatory nodules arranged in circular fashion around the pupil area of the cornea, from previous infection, especially viral and they consist of hialine plaque replacing Bowman’s membrane by hyaline material. More common in elderly women and is associated with chronic ocular surface disease such as Trachoma or severe Blepharitis.
Term
Treatment: for Salzamnn’s Nodular Degneration
Definition
Excimer laser superficial keratectomy to remove the nodules or Keratoplasty. **6.42
Term
Band Keratopathy
Definition
Corneal degeneration characterized by slow development of a horizontal gray band in the central area ,caused by calcium deposition at level of Bowman’s layer, in children with low chronic iritis , idiopathic hypercalcemia, or following the use of silicone oil for retinal detachment or in phthisis bulbi.
Term
Treatment of Band Keratopathy
Definition
: application of ethlenediaminetetraacetic acid (EDTA) after anesthetizing the cornea and scrapping off the epithelium. EDTA chelates the calcium. **6.43-44 *6.64
Term
Lipid keratopathy
Definition
;deposition of lipid and lipoproteins leaking from new vessels in the cornea , following chronic inflammation and vascularization.
Term
Terrien’s Marginal Degeneration
Definition
Peripheral thinning of the cornea that progress slowly and resulting in a ring opacity similar to arcus , sparing central corneal area of unknown etiology . **6.65
Term
White Limbal Girdle of Vogt
Definition
: Is an sub-epithelial opacity (hyaline degeneration) concentric with the limbus, consist of a chalky opacity in Bowman’s layer, but it is not a band keratopathy.
Term
Two types of White Limbal Girdle of Vogt
Definition
: 1) the opacity is discontinuous, separated from the limbus by a clear zone 2) the opacity is unbroken and continuous with the sclera with short projections extending toward the center of the cornea. ** 6.11
Term
Anterior Crocodile Shagreen:
Definition
This is due to disruptions in Bowman’s membrane and it is separation from the corneal epithelium .Bilateral, polygonal, grayish opacities, separated by clear tissue. Decrease corneal sensation, usually no reduction in VA and no vascularization. Treatment is not necessary **6.12
Term
Posterior Crocodile Shagreen
Definition
The same opacities and characteristics of above but placed in Descement’s membrane. May be familial and related to the central cloudy corneal dystrophy .Neither produces visuals symptoms.
Term
Cornea Farinata
Definition
These opacities appear grayish and are located anterior to Descement’s membrane. Farinata might be vacuoles in the keratocytes.
Term
ARCUS SENILIS
Definition
This is a grayish ring opacity in the periphery of the cornea, separated from the limbus by a zone of clear cornea. In younger patients is called JUVENILIS OR EMBRIOTOXON. **6.13 *6.58
Term
Descement’s Hypertrophy
Definition
(Hassall-Henle warts) (Cornea Guttata) This are rounded wart-like elevations (excrecences ) of the posterior surface of Descement’s membrane at the central or periphery of the cornea which tend to increase in olders. **6.27-28-29 * 6.40-41
Term
Anterior membrane
Definition
(deep epithelium, basement membrane and bowman’s membrane), MEESMANN’S CORNEAL DYSTROPHY, COGAN’S MICROCYSTICCORNEQAL DYSTROPHY, FINGERPRINT DYSTROPHY, REIS-BUCKLER’S SUPERFICIAL DYSTROPHY, RECURRENT EROSIONS, VORTEX DYSTROPHY
Term
Stromal Dystrophies
Definition
GRANULAR DYSTROPHY, LATTICE DYSTROPHY, MACULAR DYSTROPHY, FLECK DYSTROPHY, SCHNYDER’S CRISTALINE DYSTROPHY, FUCH’S EPITHELIAL/ENDOTHELIAL DYSTROPHY, POSTERIOR POLIMORPHUS DYSTROPHY
Term
Meesmann’s Corneal dystrophy
Definition
A dominant , hereditary, bilateral dystrophy involving only the corneal epithelium. It commences at 18 months of age with gradual progression, finally discovered in the older patient. It characterized by numerous small punctate opacities regularly distributed throughout the epithelium intra-palpebrally. **6.18
Term
Treatment for Meesmannn’s Corneal Dystrophy
Definition
: Lamellar Keratoplasty, if the condition causes a disturbance in vision.
Term
Cogan’s Microcystic corneal dystrophy
Definition
This consists of gray cyst that affect the eyes bilaterally in pupillary zone. The lesions can be round, comma-shaped, or oblong and granular and occur in intraepithelial spaces. Vision normal but recurrent erosions can occur.* *6,16
Term
Fingerprint Dystrophy
Definition
This consists of fine, wavy lines, anterior to Bowman’s membrane. Epithelial basement membrane dystrophy. Asymptomatic and can present recurrent erosions. Bilateral ,more frequent in woman**6.16
Term
Reis-Buckler’s Superficial Dystrophy
Definition
Hereditary, present recurrent erosions and opacification of Bowman’s. There is decreased visual acuity ,ciliary injection ,irregular astigmatism and distortion of the cornea. Begins with fragmentation of the collagen fibrils of Bowman’s with epithelial involvement secondary. Treatment : Penetrant and Lamellar keratoplasty.**6.19 * 6.33
Term
Recurrent Erosions :
Definition
this can be familial, spontaneous, or associated with another problems or traumas.
Term
Vortex Dystrophy
Definition
Rare dominantly inherited, corneal dystrophy involving superficial layers of the cornea and characterized by small brownish opacities on Bowman’s arranged in a whirlpool-shape line formation radiating out from the center of the cornea. It is also called cornea Verticillata. **6.66 *6.65
Term
Granular Dystrophy
Definition
Irregular, discrete nodules of hyaline degeneration beginning in the superficial stroma. NOTE: Good prognosis until middle age.**6.22
Term
Lattice Dystrophy
Definition
interlacing lines and nodules of amyloid deposits in collagen fibers and under epithelium. Present in first decade of life with recurrent erosions. VA Deteriorates slowly, and corneal grafting is often necessary in third or fourth decade. **6.20
Term
Macular Stromal Dystrophy
Definition
: characterized by a lot of spots forming an apparent opacity due to accumulation of MPS or glycoprotein in stroma and degeneration of Bowman’s membrane. **6.24 *6.38
Term
Fleck Dystrophy :
Definition
Autosomal Dominant, in origen. Lesions are bilateral, round, gray, and distributed through all layers of the cornea. Patients are usually unaware of the problem and no treatment is necessary.
Term
Schnyder’s Cristalline Dystrophy
Definition
autosomal dominant. Polychromatic crystals are distributed within a a ring shaped yellow corneal opacity in the anterior stroma. If VA affected Treatment with corneal graft , might be necessary.**6.69 *6.66
Term
Fuch’s Epithelial/Endothelial Dystrophy :
Definition
Dominant in origen. The endothelium fails as an effective pump with resulting edema consisting of vesicles which later become opacities, and after an extremely slow course, the cornea becomes opaque and insensitive. Ttt Penetrating keratoplasty must be performed. ** 6.27
Term
Posterior Polymorphous Dystrophy:
Definition
Dominant transmission. Plaque of calcium crystals accumulate in the deep stromal layers and vesicle-like opacities are noted on Descement’s membrane. Edema occurs, but vision is usually not affected except in sever cases and the condition is no progressive.**6.30-31 *6.42-43
Term
Corneal Changes in Inborn Errors in Metabolism
Definition
Protein and amino acid metabolism, Porphyria , Amyloidosis, Cystinosis, Alkaptonuria, Wilson’s Disease Etc.
Term
Disorders in Carbohydrate Metabolism
Definition
Hurler’s Synd. Scheie’s Synd, Morquio’s Synd. Sanfilippo’s Synd. Hunter’s Synd. Etc.
Term
Changes in Chromosomal Abnormalities
Definition
Trisomy 21(Down’s Synd, mongolism) Trisomy 13-15 (Patau’s Synd) Turner’s Synd. Etc.
Term
Collagen Disorders
Definition
Lupus Erythematosus , Sjogren’s Synd., Marfan’s Synd. Etc.
Term
Endocrine System Disorders
Definition
Diabetes Mellitus , Thyroid Disorders , Parathyroid Disoders ,Hyphosphatemia Etc.
Term
Skin diseases
Definition
Acne Rosacea, Atopic Dermatitis, Ichtiosis, Psoriasis Etc.
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