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Corneal DegenerationsApoorva Kottary 28
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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.
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Distinguished from Corneal Dystrophies
As being:• Non - Hereditary and Non - Familial• Usually Unilateral • Mostly Peripheral• More frequently seen• Vascularity and Inflammation is seen.
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Corneal degenerationsDepending upon etiology
Age - Related
Pathological Degeneration
Depending upon locationAxial
Peripheral
Classification
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Classification• Depending upon Location
I. Axial Corneal Degenerationsa) Fatty Degenerationsb) Hyaline Degenerationsc) Amyloidosisd) Calcific Degenerations (Band
Keratopathy)e) Salzmann’s Nodular Degeneration
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II. Peripheral Degenerationsa) Arcus Senilisb) Vogt’s White Limbal Girdlec) Hassall – Henle Bodiesd) Terriens’s Marginal Degeneratione) Mooren’s Ulcerf) Pellucid Marginal Degenerationg) Furrow Degeneration (Senile
Marginal Degeneration)
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• Depending upon Etiology
I.Age Related Degenerationsa) Arcus Senilisb) Vogts White Limbal Girdlec) Hassal - Henle Bodiesd) Mosaic Degenerations
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II. Pathological Degenerations:
a) Fatty Degenerationb) Amyloidosisc) Calcific Degenerationsd) Salzmann’s Nodular Degeneratione) Terrien’s Marginal Degenerationf) Mooren’s Ulcerg) Pellucid Marginal Degenerationh) Furrow Degenerationsi) Spheroidal Degeneration
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Age Related Corneal Degenerations
Arcus Senilis
Vogt’s White Limbal Girdle
Hassal - Henle Bodies
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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.
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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.
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Arcus Senilis
Lucid Interval of Vogt’s
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• It is not of importance, as it does not decrease vision or the vitality of the cornea.
• Unrelated to metabolic conditions such as hypercholesterolemia.
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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.
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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.
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Vogt’s White Limbal Girdle
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Vogt’s White Limbal Girdle
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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’.
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Corneal Guttata
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References1. Parson’s Diseases of the Eye2. Comprehensive Ophthalmology – A.K. Khurana3. Pictures Courtesy – Online Journals
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That’s all folks!Thank you