1 / 15

CORNEALEDEMA

Presentation on corneal edema with references from Khurana, Kanski's, Parsons textbooks

Sudeeptha
Download Presentation

CORNEALEDEMA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TOPIC: CORNEAL OEDEMA PRESENTED BY: ROLL NOS 66-84 DONE BY: ROLL NO:82 BATCH b

  2. CONTENTS • NORMAL FACTORS • DEFINITION & PATHOPHYSIOLOGY • SYMPTOMS • HISTORY TAKING • SIGNS • CAUSES • TYPES

  3. CORNEAL LAYERS • NORMAL FACTORS • 1) EPITHELIUM • 2) BOWMAN’S MEMBRANE • 3) STROMA • 4) DUA’S LAYER (RESISTANT) • 5) DESCEMET’S MEMBRANE (RESISTANT) • 6) ENDOTHELIUM • FACTORS WHICH DRAW WATER INTO CORNEA • 1)INTRAOCULAR PRESSURE (IOP) • 2) SWELLING PRESSURE OF STROMA- This is the tendency of stroma to swell due to interfibrillary proteoglycans and other proteins. • FACTORS WHICH DRAW WATER OUT • 1)ACTIVE PUMPING ACTION OF CORNEAL ENDOTHELIUM 2)MECHANICAL BARRIER ACTION OF ENDOTHELIUM AND EPITHELIUM

  4. DEFINITION • COMMON CAUSE OF LOSS OF CORNEAL TRANSPARENCY • ACCUMULATION OF FLUID IN THE LAYERS OF CORNEA • - ESPECIALLY BETWEEN BASAL CELLS (columnar cells of epithelium) • -BETWEEN LAMELLAE • -AROUND NERVE FIBRES OF STROMA (STROMAL HAZE)

  5. IMBIBITIONAL PRESSURE= IOP - SP

  6. SYMPTOMS • Maybe ASYMPTOMATIC • REDUCED VISION- DUE TO STROMAL HAZE • PAIN • PHOTOPHOBIA • LACRIMATION, REDNESS • COLOURED HALOS (*note- Fincham’s stenopaic slit test= remains intact) • FOREIGN BODY SENSATION

  7. HISTORY TAKING • AGE OF ONSET • DURATION • LATERALITY • FAMILY HISTORY • OCULAR MEDICATIONS • H/O SURGERY/TRAUMA • DIURNAL VARIATION

  8. SIGNS STROMA EPITHELIAL • DUE TO EPITHELIAL DEFECTS (fluorescein stain) • LUSTER LOST • MICROCYST • BULLOUS KERATOPATHY (mostly pain) • SLIT WIDER THAN NORMAL ON SLIT LAMP • DESCEMET MEMBRANE FOLDS (mostly reduced vision)

  9. BULLOUS KERATOPATHY MICROCYST STAGE PERIPHERAL EDEMA (Brown Mclean syndrome) DESCEMET MEMBRANE FOLDS BREAKS IN DESCEMET’S (Forceps injury)

  10. ENDOTHELIAL EXAM • GUTTAE SEEN • THESE ARE DROP LIKE ACCUMULATIONS ON POSTERIOR SURFACE OF CORNEA • GIVES DIMPLES/BEATEN METAL APPEARANCE ON SLIT LAMP • IN CASES LIKE FUCHS’ DYSTROPHY

  11. CAUSES • Mostly acute and stromal edema seen • INCREASED INTRAOCULAR PRESSURE (normal endothelium, acute angle closure glaucoma cases) • MECHANICAL INJURIES • CHEMICAL BURNS • RADIATIONAL INJURIES • THERMAL INJURIES • INFLAMMATION AND INFECTIONS (Herpes) INJURIES- BIRTH TRAUMA (Forceps delivery),SURGICAL TRAUMA DRUGS/ HYPOXIA (acute and stromal edema) ENDOTHELIAL FAILURE- Fuchs’ Dystrophy, Congenital Hereditary endothelial dystrophy, Posterior polymorphous dystrophy, Iridocorneal endothelial syndrome (chronic, progressive stromal edema) INFLAMMATIONS- Uveitis, Endophthalmitis, Corneal graft infection

  12. EDEMA IN AN INFANT DUE TO FORCEPS DELIVERY FUCHS’ DYSTROPHY GRAFT REJECTION EDEMA EDEMA IN PHACOMORPHIC GLAUCOMA HERPES INFECTION EDEMA

  13. TYPES • GROUND GLASS APPEARANCE • MINIMAL CHANGE • PRESENTS WITH CONTRAST SENSITIVITY • MICROCYSTIC APPEARANCE STROMAL AND EPITHELIAL EDEMA (FS)

  14. TREATMENT • TREATING ASSOCIATED CAUSES • INCREASED IOP- carbonic anhydrase inhibitors • INFLAMMATION- STEROIDS • TREATING EDEMA • HYPERTONIC AGENTS- 5% SODIUM CHLORIDE DROPS OR ANHYDROUS GLYCERINE • HOT FORCED AIR FROM HAIR DRYER • THERAPEUTIC SOFT CONTACT LENS • ENDOTHELIAL KERATOPLASTY • PENETRATING KERATOPLASTY- FOR LONG STANDING CASES

  15. THANK YOU • BIBLIOGRAPHY • A K KHURANA • PARSONS’ DISEASES OF THE EYE • KANSKI’S CLINICAL OPHTHALMOLOGY • OPHTHALMOLOGY ATLAS BY WILLS EYE INSTITUTE

More Related