This presentation discuss the corneal causes of decreased vision

1. Corneal Causes of
Decreased Vision
Subtitle
By
Dr. Amr Mounir, MD, PhD
Assistant Professor of Ophthalmology,
Sohag University

2. Introduction
It is the transparent front part of the eye that
covers the iris, pupil, and anterior chamber.
Its refractive power of the cornea is approximately
43 diopters.
Five distinct layers make up the cornea, including
the epithelium, Bowman's membrane, the stroma,
Descemet's membrane, and the endothelium
(from the exterior to interior).
The cornea is the clear outer layer at the front of
the eye.
The cornea focus light together with the lens.

3. There are several common
Conditions that affect the cornea
Injuries Keratitis

4. There are several common
Conditions that affect the cornea
Dry eye Corneal Dystrophy

5. Clinical Picture
.

6. Causes of decreased vision
Infectious
Bacterial keratitis
Fungal keratitis
Viral keratitis
Trachoma
Onchocerciasis
Leprosy

7. Causes of decreased vision
Nutritional
Vitamin A deficiency (xerophthalmia)
Inflammatory
Peripheral ulcerative keratitis
Inherited
Corneal stromal dystophies
Fuch's endothelial dystrophy

8. Causes of decreased vision
Degenerative
Keratoconus
Trauma
Penetrating trauma
Chemical injury
Iatrogenic
Pseudophakic bullous keratopathy
Dry Eye

9. Important Causes
Keratitis

10. keratitis
Bacteria and
Fungi Viruses Acanthamoeba
Systemic
Autoimmune/
Inflammatory
Local Toxic
Infectious
Non infectious
Etiology

11. Diagnostic approaches
1. Determination of the ulcer geography.
2. Categories:
A. infectious
B. noninfectious
3. Talk to your patients.
4. Ask about pain type and severity.

12. Diagnostic approaches
5. Consider the context.
6. environmental and social factors
7. ocular history
8. Examine the eye :Visual acuity , Ulcer itself
9. Culture the site of ulcer

13. Trachoma

14. Xerophthalmia

16. Peripheral ulcerative keratitis
Non INFECTIOUS
INFECTIOUS
No pain
Pain
No discharge
Discharge
AC reaction: absent
AC reaction: present
Peripheral
Central
Trauma: -------
Trauma : ++++

17. Peripheral ulcerative keratitis

18. Mooren's ulcer

19. Terrien's Marginal Degeneration

20. Corneal dystophies

21. Fuchs’ corneal endothelial dystrophy

22. ECTATIC CONDITIONS OF THE CORNEA
A. Post-Inflammatory B. Degenerative (Non-inflammatory)
1. Keratectasia 1. Keratoconus
2. Anterior (corneal) 2. Keratoglobus
staphyloma.

23. KERATOCONUS (Conical Cornea)

24. ● Gross Pathological changes:
Thickness: The center of the cornea is markedly thin.
normal
keratoconus

25. 2. Shape: conical with apex usually
below and nasal to the corneal center.
Later, the apex becomes opacified
(Acute hydrops).
3. A brown ring surrounds the base of
the cone due to iron deposition in the
epithelial cells (Fleischer's ring)

26. Acute hydrops in KC
Acute hydrops & Corneal opacity

27. Post Lasik Ectasia

28. Chemical injury

29. Pseudophakic bullous keratopathy

30. Dry Eye

31. Thank You