STAPHYLOMA VIRAL KERATITIS
DR M SAQUIB
MBBS,MS , FSCEH DELHI,FHVDESAI PUNE,
EX REGISTRARA JNMCH,AMU
CONSULTANT OPHTHALMOLOGIST
HOD D/O OPHTHALMOLOGY
G.S .MEDICAL COLLEGE
Founder sec: MEDICS India , www.medicsngo.org
Anterior Staphyloma
•Acquired /Congenital defect
•Due to weakness & thinning of scleral-uveal coat
•Severe Progressive Myopia
•Trauma
•Necrotizing Infection
•Scleitis
•Inflammmation
•Surgical Weakening Of Sclera
•Radiotherapy
Ant Staphyloma ( dd Adherent Leucoma)
Pseudocornea ( scar formed from organised
exudates and fibrous tissue covered with
epithelium)ughing of cornea
Anterior Staphyloma
•Abnormal protrusion -front of the eye –Cornea,Sclera.
•Ectasia of Pseudocornea ( scar formed from organised
exudates and fibrous tissue covered with epithelium),due
to total sloughing of cornea
Iris behind .
LOCALISED BULGING ,thinningoftheouter, coat of
the eye ball ( Sclera ,Cornea) linedbyuvealtissue..f
the eye
Intercalary Staphyloma
•Localised Bulge in LIMBAL area
•Lined by ROOT OF IRIS
•CAUSES :
• Trauma /Perforated Injury
• Peripheral Corneal Ulcer
• Collagen Fiber Disease ( Marfan)
CiliaryStaphyloma
•Bulge of weak Sclera Lined by CILIARY BODY
•2-3 mm away from Limbus
•CAUSES : Perforation
Scleritis
Absolute Glaucoma
Equatorial Staphyloma
•Bulge of Sclera in Equatorial region
•Lined by Choroid
•Common where vortex vein perforate sclera (14mm behind limbus)
•CAUSES: Scleritis
• Scleraldegeneration
• Pathological Myopia
• Chronic uncontrolled Glaucoma
EQUATORIAL STAPHYLOMA
Posterior Staphyloma
•Circumscribed outpouching of the posterior
fundus .Bulge of weak Sclera lined by Choroid
behind the Equator .
Cause :
Pathological Myopia
Posterior Scleritis
Perforating Injury
Infection
•Congenital Weak Bruch’s membrane, Retinitis pigmentosa,
Aalport’s syndrome,Pseudoxanthoma elasticum, and Tilted-disc
syndrom
Pathological Myopia
•Up to 50% of patients with pathologic myopia are
reported to have a staphyloma.
•The definition of pathologic myopia include the
posterior staphyloma.
Not all patients with myopia develop a staphyloma.
Ophthalmoscopy
•Staphylomas are associated with other macular
Complations Related To Myopia,
•Choroidal neovascularization,
•Retinoschisis,
•Glaucomatous optic neuropathy.
•In the Non-Myopic-to trauma or infection,
and rarely, surgery.
BLUE SCLERA
•A bluish coloration of the whites of the eyes.
•The blue color is caused by thinness and transparency of
the collagen fibers of the sclera, allowing the veins in the
underlying tissue to show through.
•Conditions,
•particularly connective tissue disorders. These include
Osteogenesis imperfecta,Marfan's syndrome,Ehlers-
Danlos syndrome,Pseudoxanthoma elasticum, and
Willems De Vries syndrome.
Spheroidal degeneration
Treatment
Central spread, coalescence and
opacification
Advanced lesions become
nodular and elevated
•Rare, typically affects outdoor workers
•Starts with peripheral, interpalpebral, small amber-coloured
granules in superficial stroma
•Debridement or superficial keratotomy if mild
•Keratoplasty if severe
Progression
Salzmann nodular degeneration
•
Uncommon
, unilateral
or bilateral
•Raised
hyaline
plaque
•Between
Epithelium
and
Bowmans .
•Secondary to
chronic
keratitis,
Phlyctenular
keratitis,
Rosacea
Trachoma
•Discrete superficial stromal opacities
and nodules
•Base of nodule may be surrounded by
iron deposits
Treatment-similar to spheroid degeneration