Miscellaneous Corneal Disorders

Question 1

Mooren’s Ulcer

Answer 1

peripheral stromal ulceration that progresses circumferentially
autoimmune with no systemic complications

Question 2

Forms of Mooren’s Ulcer

Answer 2

older- one eye

younger- both eyes and more aggressive

Question 3

Signs of Mooren’s Ulcer

Answer 3

peripheral, mainly stromal, ulceration

Question 4

Tx of Mooren’s Ulcer

Answer 4

corneal specialist
topical steroids
immunosuppressants + collagenase inhibitors
surgery

Question 5

Peripheral Ulcerative Keratitis

PUK

Answer 5

associated with systemic disease

RA; Wegener’s granulomatosis

Question 6

Signs of PUK

Answer 6

crescent shaped destructive lesions at juxtalimbal corneal stroma
neighboring scleritits

Question 7

Tx of PUK

Answer 7

systemic immunosuppression

surgery by corneal specialist

Question 8

Terrien’s Marginal Degeneration

Answer 8

idiopathic form of corneal peripheral thinning
slowly progressive
non-inflammatory- no infiltrates or redness

Question 9

Symptoms of Terrien’s Marginal Degeneration

Answer 9

none

blur from astigmatism

Question 10

Signs of Terrien’s Marginal Degeneration

Answer 10

peripheral gutter

superficial corneal vascularization, opacification, lipid deposits

Question 11

Neurotrophic Keratopathy

Answer 11

epithelial breakdown and persistent ulceration that occurs with loss of trigeminal innervation

Question 12

Signs of Neurotrophic Keratopathy

Answer 12

reduced corneal sensation
non-healing epithelial defects with thickened/ rolled edges
progressive stromal melt with minimal discomfort

Question 13

Tx for Neurotrophic Keratopathy

Answer 13

discontinue all drops
anti-collagenase meds
corneal specialist

Question 14

Exposure Keratopathy

Answer 14

from incomplete lid closure

Question 15

Signs of Exposure Keratopathy

Answer 15

dry eye symptoms

punctate epithelial changes that can progress to ulceration

Question 16

Tx of Exposure Keratopathy

Answer 16

lubricants, lid taping, BCL

surgery

Question 17

Thygeson’s SPK

Answer 17

idiopathic, bilateral
episodic
appearance of corneal opacities causing irritation and blur

Question 18

Signs of Thygeson’s SPK

Answer 18

multiple small, elevated, gray epithelial disruptions across central cornea

Question 19

Mx of Thygeson’s SPK

Answer 19

lubricants- mild cases
topical steroids
BCL

Question 20

Recurrent Corneal Erosion Syndrome

Answer 20

epithelial erosions caused by poor attachment to underlying basement membrane
associated with prior trauma or corneal dystrophies

Question 21

Symptoms of Recurrent Corneal Erosion Syndrome

Answer 21

significant pain

worse in morning

Question 22

Signs of Recurrent Corneal Erosion Syndrome

Answer 22

epithelial defects

basement membrane irregularities- microcysts, swirls

Question 23

Mx of Recurrent Corneal Erosion Syndrome

Answer 23

lubricants
antibiotics
combo of doxycycline and topical corticosteroid (prednisolone or fluorometholone)

Question 24

Filamentary Keratopathy

Answer 24

mucus and cellular debris attach to epithelial surface

Question 25

Causes of Filamentary Keratopathy

Answer 25

aqueous deficient dry eye, SLK, toxicity to drops

Question 26

Tx of Filamentary Keratopathy

Answer 26

removal of filaments

acetylcysteine breaks up mucus strands

Question 27

Xerophthalmia

Answer 27

ocular signs and symptoms associated with Vit A deficiency

most common cause of childhood blindness

Question 28

Tx of Xerophthalmia

Answer 28

Vit A supplements

intense lubrication

Question 29

Signs of Xerophthalmia

Answer 29

Bitot Spots- triangular patches of keratinized epithelium
lusterless cornea
erosions that can lead to melting