Staphyloma A S Staphyloma case A S.pptx

This slide gives a detailed study on the topic of Staphyloma which is prepared Young graduate. This would be beneficial for all students who seek genuine and simplified version of study of Staphyloma.

1. STAPHYLOMAS Presentation by –Gaadha G Nair

2. Introduction The name is derived from staphylos which means a bunch of grapes Definition –it is the localised bulging of the weak and thin outer tunica of the eyeball This is caused due to the thinning and perforation of cornea and sclera It almost has a bluish to black colour as due to the thinning of the outer covering the pigmented layer becomes visible ...

3. Types There are mainly 3 types Anterior staphyloma Posterior staphyloma Equatorial staphyloma Intercalary staphyloma Ciliary staphyloma

4. Anterior staphyloma It is associated with ectasia of cornea and iris The most common cause is perforating corneal ulcer or other injuries Pathogenesis In a patient with slouching cornel ulcer when the whole cornea sloughs out the inflammediris is covered with exudates Ultimately these exudates organise and form a fibrous layer over which the conjunctival epithelium rapidly grows and thus a pseudo cornea is formed .Since the pseudo cornea is thin and cannot withstand the IOP it usually bulges out along with the plastered iris tissue

5. Presenting symptoms Loss of vision Bluish discolouration Bulging Tearing Sensitivity to light

6. Treatment Most of the times there is no chance of getting useful vision in such eyes .therefore treatment is carried out to improve the cosmetic appearance Localised staphylectomy under heavy dose of oral steroids may be carried out Evisceration is indicated in cases of bleeding anterior staphylomas

7. After healing cosmetic artificial she’ll may be advised In a patient where there is chance of getting useful vision keratoplasty or keratoprosthesis may be performed

8. Intercalery staphyloma It is the name given to the localised bulge in limbal area lined by root if iris It lies between the iris and the ciliary body The most common cause is absolute glaucoma .There may be associated secondary angle closure glaucoma which may cause progressive of bulge if not treated

9. Pathogenesis There is ectasia of sclera and root of iris .it results due to ectasia of weak scar tissue formed at the limbus following healing of a perforating injury or a peripheral corneal ulcer Defective vision occurs due to marked corneal astigmatism and angle closure glaucoma

10. TREATMENT Staphylectomy under heavy doses of oral steroids

11. Ciliary staphyloma As the name implies it is the bulge of weak sclera lined by ciliary body .It occurs about 2-3mm away from the limbus There is ectasia of sclera and the ciliary body . Its common causes are thinning of sclera following perforating injuries , scleritis and absolute glaucoma

12. Uveal tissue shining through sclera

13. Equatorial staphyloma It results due to bulge of sclera lined by the choroid in 5he equatorial region Causes- sclerosis and degeneration of sclera in pathological myopia There is ectasia of the sclera and the choroid due to absolute glaucoma It occurs more commonly at the regions of sclera (unsupported by the muscle )which are perforated by the vortex veins (exit of vortex veins )

14. Posterior staphyloma The sclera may bulge out at the posterior pole due to thinning It refers to bulge of weak sclera lined by the choroid behind the equator There is ectasia of sclera and the choroid commonly in chorioretinal degeneration due to high myopia

15. Causes Pathological myopia Posterior sclerosis Perforating injuries

16. DIAGNOSIS It is diagnosed on ophthalmoscope The area is excavated with retinal vessels dipping in it ( just like marked cupping of optic disc in glaucoma ) It’s floor is focused with minus number lenses in ophthalmoscope as compared to its margin

17. Peripapillary staphyloma It’s a non hereditary unilateral condition in which a relatively normal disc sits at the base of a deep excavation whose walls as well as the surrounding choroid show atrophic changes Unlike other excavated optic disc anomalies ,it is rarely associated with other congenital defects or systemic diseases Treatment Reinforcement surgery by facial later or silicon band in cases of high myopia

18. Thank you