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Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
Cornea 4 class
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Cornea 4 class

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  • 1. CORNEA
  • 2. INTERSTITIAL KERATITIS <ul><li>Def –Inflammation of the corneal </li></ul><ul><li>stroma without primary involvement </li></ul><ul><li>of the epithelium or endothelium </li></ul><ul><li>Causes </li></ul><ul><li>Syphilis </li></ul><ul><li>Tuberculosis </li></ul><ul><li>Cogan's syndrome </li></ul>
  • 3. SYPHILITIC INTERSTITIAL KERATITIS <ul><li>Bilateral </li></ul><ul><li>Manifests between 5-15 years of age </li></ul><ul><li>Manifestation of local antigen antibody reaction </li></ul>
  • 4. SYPHILITIC IK <ul><li>Clinical features </li></ul><ul><li>Hutchisons triad </li></ul><ul><li>IK </li></ul><ul><li>Hutchisons teeth </li></ul><ul><li>Vestibular deafness. </li></ul>
  • 5. SYPHILITIC IK <ul><li>3 stages </li></ul><ul><li>Initial progressive stage -2 weeks </li></ul><ul><li>Corneal Edema: periphery – center </li></ul><ul><li>Anterior uveitis </li></ul><ul><li>Pain , lacrimation, photophobia, circumcorneal congestion </li></ul><ul><li>Ground glass appearance </li></ul>
  • 6. INTERSTITIAL KERATITIS
  • 7. SYPHILITIC IK <ul><li>Florid stage- 2 months </li></ul><ul><li>Eye is acutely inflamed </li></ul><ul><li>Deep vascularization covered by hazy cornea appear dull reddish pink- salmon patch appearance </li></ul><ul><li>Epaulette- superficial vessels and conjunctiva heap at the limbus </li></ul>
  • 8. INTERSTITIAL KERATITIS
  • 9. SYPHILITIC IK
  • 10. SYPHILITIC IK <ul><li>Stage of regression -1-2 years </li></ul><ul><li>Acute inflammation resolves </li></ul><ul><li>Clearing of cornea from periphery to center </li></ul><ul><li>Resolution with some opacities and ghost vessels - non perfused vessels </li></ul>
  • 11. INTERSTITIAL KERATITIS Non-perfused &quot;ghost&quot; vessels.
  • 12. SYPHILITIC IK <ul><li>Diagnosis - positive VDRL </li></ul><ul><li>Treatment </li></ul><ul><li>Local </li></ul><ul><li>Topical steroids </li></ul><ul><li>Atropine </li></ul><ul><li>Keratoplasty if dense opacities </li></ul><ul><li>Systemic – high dose of penicillin </li></ul>
  • 13. INTERSTITIAL KERATITIS End stage- scarring
  • 14. TUBERCULOUS IK <ul><li>Features similar to syphilitic IK </li></ul><ul><li>Unilateral </li></ul><ul><li>Sectoral- lower sector </li></ul><ul><li>Treatment- systemic antitubercular drugs, topical steroids and cycloplegics </li></ul>
  • 15. INTERSTITIAL KERATITIS <ul><li>Cogan’s syndrome </li></ul><ul><li>Interstitial keratitis – idiopathic </li></ul><ul><li>Tinnitus </li></ul><ul><li>Vertigo </li></ul><ul><li>Deafness </li></ul>
  • 16. Exposure keratitis <ul><li>Improper wetting of the ocular surface by the tear film due to inability to close the eyes on blinking despite normal tear production </li></ul><ul><li>Causes </li></ul><ul><ul><li>Lagophthalmos </li></ul></ul><ul><ul><li>Proptosis </li></ul></ul><ul><ul><li>Orbital tumor </li></ul></ul><ul><ul><li>Facial nerve paralysis </li></ul></ul>
  • 17. Exposure keratitis <ul><li>Signs </li></ul><ul><ul><li>Inferior punctate epithelial erosion </li></ul></ul><ul><ul><li>Secondary infection </li></ul></ul><ul><ul><li>Severe ulceration </li></ul></ul>
  • 18. Exposure keratitis
  • 19. Exposure keratitis
  • 20. Exposure keratitis <ul><li>Treatment </li></ul><ul><li>Lubricant eye drops </li></ul><ul><li>Taping of lids </li></ul><ul><li>Antibiotics </li></ul><ul><li>Tarsorraphy </li></ul><ul><li>Treat the cause </li></ul>
  • 21. Neurotrophic Keratitis <ul><li>Occurs in anesthetic cornea </li></ul><ul><li>Paralysis of sensory nerve supply of the cornea </li></ul><ul><ul><li>Trigeminal nerve </li></ul></ul><ul><li>Altered metabolic activity of epithelium in the absence of sensation </li></ul>
  • 22. Neurotrophic Keratitis <ul><li>Causes </li></ul><ul><li>Congenital- Riley-Day syndrome </li></ul><ul><li>Acquired </li></ul><ul><ul><li>Trigeminal nerve dysfunction- infection, destruction, surgery, injury to gasserian ganglion </li></ul></ul><ul><ul><li>Leprosy </li></ul></ul>
  • 23. Neurotrophic Keratitis <ul><li>Clinical features – </li></ul><ul><ul><li>No pain , no lacrimation </li></ul></ul><ul><ul><li>Complete loss of corneal sensations </li></ul></ul><ul><ul><li>Ciliary congestion </li></ul></ul><ul><ul><li>Punctate epithelial erosion to severe ulceration </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>As an ulcer </li></ul></ul><ul><ul><li>Tarsorrhaphy </li></ul></ul>
  • 24. Tarsorrhaphy
  • 25. THANK YOU
  • 26. Keratitis associated with diseases of skin and mucous membrane <ul><li>Rosacea keratitis </li></ul><ul><li>Chronic progressive idiopathic condition </li></ul><ul><li>Facial skin and eyes </li></ul><ul><li>Irritation, burning , tearing, redness </li></ul><ul><li>Inferior PEE, marginal keratitis, peripheral neovascularisation </li></ul><ul><li>Treatment </li></ul>
  • 27. Keratitis associated with diseases of skin and mucous membrane <ul><li>Rosacea keratitis </li></ul><ul><li>Chronic progressive idiopathic condition </li></ul><ul><li>Facial skin and eyes </li></ul>
  • 28. Keratitis associated with Systemic collagen vascular disorders <ul><li>Rheumatoid arthritis </li></ul><ul><li>Systematic vasculitidis </li></ul><ul><li>– wegeners granulomatosis </li></ul><ul><li>- polyartertitis nodosa </li></ul>
  • 29. Rheumatoid arthritis <ul><li>Scelrosing keratitis </li></ul><ul><li>Peripheral corneal thinning </li></ul><ul><li>Acute stromal keratitis </li></ul><ul><li>Treatment </li></ul><ul><li>- topical : steroids </li></ul><ul><li>: cyclosporine </li></ul><ul><li>- systemic: cytotoxic </li></ul><ul><li>-keratoplasty </li></ul>

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