Ocular media
Fiona Rowe in Visual Fields via the Visual Pathway, 2016
Congenital anomalies include abnormalities of size (e.g. megalocornea, microcornea), abnormalities of curvature (e.g. keratoglobus) and opacities. A variety of factors cause congenital corneal anomalies including genetic, metabolic and developmental causes with more common causes of opacity as follows: SclerocorneaTears in Descemet membrane (e.g. birth trauma)Ulcer (e.g. bacterial)Metabolic (e.g. mucopolysaccharidoses)Posterior corneal defect (e.g. Peters anomaly)Endothelial dystrophy (e.g. congenital hereditary endothelial dystrophy)Dermoid (e.g. cyst)
Diagnosis and Treatment of Fungal Keratitis
Mahendra Rai, Marcelo Luís Occhiutto in Mycotic Keratitis, 2019
The growth patterns of fungal pathogens are related to the following clinical features: (1) Keratopathy manifests as an elevated lesion on the cornea like a carpet, covering the underlying inflammatory necrotic tissue and the inner normal corneal tissue. Patients are clinically characterized by a large-area, slowly developed, superficial corneal lesion, with mild corneal stromal edema, and usually without satellite lesions or immune rings. The anterior chamber reaction is slight. Fungal hyphae can be easily found in corneal scrapings. (2) Keratopathy is mainly in the stroma, with fungal hyphae growing vertical or horizontal, and obvious inflammatory cell infiltration around the lesion. Clinically, it is a single ulcer, often reaching the deep corneal stroma, with lipid-like pus on the surface and marked satellite lesions all around accompanied by pseudopods. (3) The diseased cornea shows fungal hyphae in all layers, which are vertically embedded in the tissue, and even reach the Descemet Membrane (DM). The severe inflammation causes coagulative necrosis, whereas the mild inflammatory reaction is displayed as mixture of inflammatory tissue and normal tissue. Patients present with obvious inflammatory reaction and a wide range of lesions, often a full-thickness corneal inflammation. There are distinct satellite lesions and pseudopods around the ulcer, all accompanied by hypopyon, in a short course of disease.
Vancomycin
Anton C. de Groot in Monographs in Contact Allergy, 2021
A 76-year-old man presented with progressive pruritus, soreness, burning, photophobia, and tearing in his left eye 3 days after completing 2 weeks of treatment with 5% vancomycin eye drops for treatment of recurrent endoph-thalmitis. On examination, a severe periorbital erosive skin rash and swelling in the left eyelid were noted. Slit-lamp microscope examination revealed severe congestion of the left conjunctiva, central epithelial defects, stromal edema, and Descemet membrane striae of the left cornea. Intradermal injections with 0.005% and 5% vancomycin reconstituted with sterile water were positive at immediate (15 minutes; caused by non-allergic histamine release) and delayed (48 hours) readings. Patch tests with vancomycin 0.005% and 5% were positive after 48 hours (3).
Studies on the Effectiveness of Ozone Therapy on the Treatment of Experimentally Induced Keratitis with Candida albicans in Rabbits
Published in Seminars in Ophthalmology, 2022
Kemal Varol, Ayşe Nedret Koç, Latife Çakır Bayram, Hatice Arda, İhsan Keleş, Metin Ünlü, Vehbi Güneş, Gencay Ekinci, İlknur Karaca Bekdik, Mustafa Altay Atalay
On light microscopic examination, the cornea was observed to consist of five layers. Basal columnar cells, intermediate polygon cells, and superficial squamous cells were present in the multi-layer squamous nonkeratinized layer. Under the corneal epithelium (Bowman’s layer). Secondary propria consisted of collagen fibers and scattered spindle-shaped stromal cells arranged at regular intervals. The Descemet membrane was present just below the stroma and was covered by the endothelium of Descemet. Normal corneal morphology was observed in the negative control group. In this group, the lamellar structure of the stroma was regular. There was no change in the size and shape of the corneal epithelial cells. Keratocytes are neatly sorted. Keratin is not available (Figure 2. A.1).
Graft Size and Double Scroll Formation Rate in Descemet Membrane Endothelial Keratoplasty
Published in Current Eye Research, 2022
Hiroshi Matsumae, Takefumi Yamaguchi, Yuki Kusano, Shigeto Shimmura, Akira Kobayashi, Yuki Morizane, Jun Shimazaki
Descemet membrane endothelial keratoplasty (DMEK) is currently the standard surgical procedure for bullous keratopathy and Fuchs endothelial corneal dystrophy (FECD) owing to less irregular astigmatism in the posterior corneal surface, faster visual recovery, less graft rejection, and superior overall visual outcomes compared to penetrating keratoplasty and Descemet stripping automated endothelial keratoplasty.1–3 However, DMEK surgery is technically challenging and requires experience in graft preparation, donor insertion, and graft unfolding. To overcome these issues, Fogla et al.4 developed a novel surgical technique of intentional double scroll formation of donor Descemet membrane (DM) within a glass tube inserter for donor insertion and unfolding in DMEK (hereafter referred to as the Fogla technique), which allows controlled delivery of donor DM scroll into the anterior chamber (AC) and assists in maintaining its correct orientation for atraumatic unfolding using minimal donor manipulation. After adopting this technique in our DMEK procedure, we noted that while some of the donor DMs easily formed a double scroll configuration, some did not. In the current study, we evaluated the success rate and usefulness of the Fogla technique in the DMEK procedure. Moreover, the association of the DM graft characteristics and the tendency to form a double scroll configuration within a glass tube and unfolding time was evaluated comparing single and double scroll configurations in both clinical setings and ex vivo experiments.
A family of fuchs endothelial corneal dystrophy and anterior polar cataract with an analysis of whole exome sequencing
Published in Ophthalmic Genetics, 2020
Xue Jiang, Xin Jin, Nan Zhang, Hong Zhang
The proband’s sister II-9 and her daughter III-11 and son III-12 had corneal guttae phenotype with no anterior polar cataract (Figure 1e,f), the same as II-11, II-12, II-13, and III-5. (See Table 1). Patients in this family had FECD as the common feature. Most corneal guttae was bilateral with an almost equal degree of progression in Descemet membrane, and the central corneal injury was more serious than the peripheral endothelial injury. The degree of injury varies from person to person. Only the sub-pedigree of the proband had anterior polar cataract at the same time. Anterior polar cataract was found around the age of 10, perhaps even earlier in this family. There was no family history of other systemic abnormalities. No obvious abnormality was found in an ophthalmic examination of other members. Fundus examination showed no abnormalities in all subjects.
Related Knowledge Centers
- Basement Membrane
- Stroma of Cornea
- Corneal Endothelium
- Cornea
- Anterior Chamber of Eyeball
- Fuchs' Dystrophy
- Wilson's Disease
- Kayser–Fleischer Ring
- Haab'S Striae