Disorders of Cornea , iris + cataracts

What is this condition and describe?

Bacterial/Fungal Keratitis

• conjunctival hyperaemia

• epiphora

• corneal lesion - mid-peripheral and inferior

• stromal infiltration

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Herpes Simplex Keratitis

• dendritic ulcer

• stained using fluorescein

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• Herpes Zoster opthalmicus

• vesicular rash affecting forehead, upper eyelid and nose - hutchingsons sign

• redness

• uni-lateral

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Acanthamoeba Keratitis

• white corneal ulcer

• conjunctival hyperaemia

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• Marginal Keratitis

• small lesions in peripheral cornea

• conjunctival hyperaemia

• arcuate shaped ulcer

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CL associated peripheral corneal ulcer / CL associated Keratitis

• stained peripheral corneal ulcer

• mild conjunctival hyperaemia

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• Phlyctenulosis

• sub epithelial nodules (phylcten) located in conjunctiva

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• Ocular Rosacea

• hyperaemic thickened lids

• telangiectasia of lid margins

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• Corneal abrasion

• epithelial defect which stains with fluorescein

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• corneal foreign body

• at 7-8 o'clock small and round mid-periphery

• rust ring

Describe and what’s the diagnosis?

• Dellen

• localised depression (stromal thinning and compaction)

• at 9’o’clock in peripheral cornea

• conjunctival hyperaemia adjacent to thinning

• adjacent elevation - pinguecula

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Mooren’s ulcer

• crescent shaped , peripheral cornel thinning from 3 to 6’o’clock

• conjunctiva injection inferonasally

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• Arcus

• circumferential opacity - white ring in peripheral cornea

• clear zone of 1mm between edge of opacity and limbus

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• Vogt Limbal Girdle

• chalky white crescent near limbus , 3 and 9 o’clock

• clear zone between crescent and limbus

• mild conjunctiva hyperaemia

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• Crocodile Shagreen

• Faint reticular polygonal network of stromal opacities

• white/grayish opacities

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Band Keratopathy

• White opacification at 3 o'clock + 9 o’clock

• in periphery of cornea, extends to centre of cornea

Describe and give Diagnosis

Salzmann’s nodular degeneration

• superficial blue-white nodules

• slightly elevated in cornea

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• Corneal Verticilata

• white , whirl shaped opacities

• inferior cornea branches out

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• Epithelial basement membrane dystrophy

• fine refractive lines - fingerprints

• diffuse grey patches - maps

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• Meesman’s dystrophy

• multiple, tiny uniform epithelial microcysts

• maximum in centre , less in periphery and spare the limbus

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• Reis Bucklers dystrophy

• grey/white subepithelial opacities

• reticular/honeycomb pattern

• most dense centrally

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• Lattice dystrophy

• branching criss-crossed lines of amyloid

• on central cornea

• covering pupil

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• Macular corneal dystrophy

• greyish opacities

• stromal haze

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• Granular dystrophy

• white crumb like opacities

• in central cornea

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• Fuchs endothelial dystrophy

• corneal oedema

• haze of stroma

• Corneal guttata —> beaten metal appearance

• brown pigment spots

• lines are fold in descemets membrane

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• Keratoconus

• conical distortion of cornea

describe and diagnosis

• Penetrating Keratoplasty

• sutures around peripheral cornea circumferentially

Describe and diagnosis

• pellucid marginal degeneration

• inferior crescent shaped band at 8 o'clock

• peripheral cornea

describe and give diagnosis

• Acute hydrops

• corneal oedema

• Grade 3 conjunctival hyperaemia

• milky white opacification involving central and inferior cornea

Describe and diagnosis

• Graft rejection

• Khodadoust line extending from 1 to 7 o’clock

• transplant oedema

• conjunctiva hyperaemia around limbus

• anterior ciliary injection

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• Aniridia

• large section of Iris missing

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• Coloboma

• key-hole shaped pupil inferiorly - notch in iris

• diffuse conjunctival hyperaemia

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• Persistent Pupillary Membrane

• iris strands across pupil from iris to lens

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• Lish Nodules

• Brown nodules over iris

• round elevations varying in size

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• Busacca and Koeppe nodules

• Busacca nodules —> deeper into iris

• Koeppe nodules —> margin of iris

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• Iris Naevus

• Flat, brown pigmented lesion

• at 5 o'clock extends from pupillary margin to mid-periphery of cornea

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• Iris Melanoma

• inferior half of iris

• pupil distortion

• surface blood vessels

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• Ciliary body tumours

• brown pigment at edge of iris

• dilated episcleral vessels

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• Albinism

• Iris transillumination

• pale blue eyes, pale skin

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• Iris Prolapse

• Tear drop pupil shape

• lesion through cornea

• some iris protruding through lesion and cornea

• conjunctival hyperaemia

describe + diagnose

• Rubeosis

• new blood vessels on iris surface

• near pupil margin

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• Posterior synechiae

adhesions of iris to lens - 1 inferior at 6' o clock , 1 at 10 o'clock and 2 superior

describe and give diagnosis

• Iris Bombe

• iris pushed forward like doughnut

• irregular pupil

Describe and give diagnosis ?

• RE anterior uveitis

• conjunctival injection

• epiphora

• lid oedema

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• yellowish lesion with fluffy edges

describe and diagnose

• Eupicapsular stars and PPM

• little stellate pigment spots on anterior surface of lens

• little strand at pupil margin

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• Mittendorf Dot

• small, round, circular opacity on posterior lens capsule

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• Pseudoexfoliation

• little, white flaky material - dandruff like

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• Ectopia Lentis

• dislocation of lens

describe and give diagnosis

• Aphakia

• neovascularisation at top

• triangle shape - missing iris , trabeculectomy

describe and diagnose

• AC intraocular lens

• stitches at top