Corneal Degeneration's, Ophthalmology

Ophthalmology, SIMS & RC, RGUHS

1. Corneal Degenerations Apoorva Kottary 28

2. Corneal Degenerations Degenerative changes in the cornea. Definition: Corneal degeneration refers to the conditions in which normal cells undergo some degenerative changes under the influence of age or some pathological condition . 2

3. Distinguished from Corneal Dystrophies As being: Non - Hereditary and Non - Familial Usually Unilateral Mostly Peripheral More frequently seen Vascularity and Inflammation is seen. 3

4. 4 Classification

5. Classification Depending upon Location Axial Corneal Degenerations Fatty Degenerations Hyaline Degenerations Amyloidosis Calcific Degenerations (Band Keratopathy ) Salzmann’s Nodular Degeneration 5

6. II. Peripheral Degenerations Arcus Senilis Vogt’s White Limbal Girdle Hassall – Henle Bodies Terriens’s Marginal Degeneration Mooren’s Ulcer Pellucid Marginal Degeneration Furrow Degeneration (Senile Marginal Degeneration) 6

7. Depending upon Etiology Age Related Degenerations Arcus Senilis Vogts White Limbal Girdle Hassal - Henle Bodies Mosaic Degenerations 7

8. II. Pathological Degenerations: Fatty Degeneration Amyloidosis Calcific Degenerations Salzmann’s Nodular Degeneration Terrien’s Marginal Degeneration Mooren’s Ulcer Pellucid Marginal Degeneration Furrow Degenerations Spheroidal Degeneration 8

9. Age Related Corneal Degenerations 9

10. Arcus Senilis It is the annular lipid infiltrations of the corneal periphery seen in the elderly . Age – related degeneration occurring bilaterally in 60% of people aged 40 to 60 years. And almost all individuals aged over 80 years. 10

11. Clinical Features Commences as a crescentric grey or white arc in the superior and inferior quadrant and progresses to form a ring around the cornea, 1mm wide ring Lucid interval of Vogt’s – the clear zone which separates the ring of opacity from the limbus . Peripheral border is sharp and inner border is diffuse. Rarely double ring of Arcus is seen. 11

12. Arcus Senilis Lucid Interval of Vogt’s 12

13. It is not of importance, as it does not decrease vision or the vitality of the cornea. Unrelated to metabolic conditions such as hypercholesterolemia. 13

14. Arcus Juvenilis Similar to Arcus Senilis but occurs in individuals aged less than 40 years. Rare condition Associated with Hypercholesterolemia Diagnostic feature: Presence of a line of clear cornea between opacity and limbus . 14

15. Vogt’s White Limbal Girdle Age related which appears as a bilateral chalky white opacities in the inter - palpebral area both nasally and temporally. Opacity in the Bowman's Membrane . 15

16. 16 Vogt’s White Limbal Girdle

17. 17 Vogt’s White Limbal Girdle

18. Hassal - Henle Bodies Drop shaped excrescences of hyaline material projecting into the anterior chamber around the corneal periphery Arise from Descemet’s membrane Commonest senile change. In pathological changes, they become larger and invade the central area and the conditions is called ‘Corneal Guttata ’ . 18

19. 19 Corneal Guttata

20. References 1. Parson’s Diseases of the Eye 2. Comprehensive Ophthalmology – A.K. Khurana 3. Pictures Courtesy – Online Journals 20

21. That’s all folks! Thank you 21