3. 1. Micro-cornea
Corneal diameter <10mm.
It can be unilateral or
bilateral.
Eye may be normal in size or
smaller
Hypermetropia is present.
2. Megalo-cornea
Corneal diameter is >13mm.
Eyeball is normal otherwise.
3. Micro-
ophthalmos
The entire eye is small with
axial length at least 2
standard deviations below
the mean for age.
Features of dysgenesis:
Coloboma, Orbital cyst
Having CNS abnormalities.
4. 4. Nanophthalmo
s
Eye is structurally normal
apart from small axial length
of <20mm.
Ocular associations
include:
• Glaucoma (esp. angle
closure)
• Hypermetropia
• Ametropia
• Amblyopia
5. Sclero-cornea
Peripheral corneal
opacification
No visible demarcation
between cornea and sclera.
Appearance of reduced
corneal diameter.
In few cases, entire cornea
get opacified.
6. Cornea Plana
The cornea is flatter than
normal.
Hypermetropia
6. 1. Epithelial
Dystrophy
Affects the anterior cornea
Thickened grey epithelium
Irregular or comma shaped putty grey
patches
Fine refractile parallel curvilinear lines
Results in decreased vision/ recurrent
corneal erosions.
Risk factors: family history, trauma,
LASIK or intraocular surgery.
2. Ant. Stromal
Autosomal dominant pattern.
Onset is usually during
childhood
Deposits increases in density
with age.
Presence of grey white fine,
round, sub-epithelial opacities,
most dense centrally.
7. 3. Stromal
Dystrophy
Hereditary
Affecting central part of
cornea
Can be granular, macular or
lattice like in appearance.
Treatment of choice is
keratoplasty.
4. Endothelial
Dystrophy
Cortical guttata (beaten
metal appearance)
Stromal oedema.
Present with blur vision
worse in the mornings.
Micro-cysts and bullae
Can be associated with open
angle glaucoma.
9. Arcus Senilis
Bilateral annual lipoid
infiltration of cornea in aged
persons.
Usually occurs above 40
years of age.
Greyish white circular line
concentric with limbus.
Does not affect vision and
does not require treatment.
Arcus Juveniles
Usually occurs below 40
years of age.
It does not affect vision.
Band-shaped
Common in old, blind and
shrunken eyes.
Associated with hypothyroidism,
vitamin D deficiency and
sarcoidosis.
Due to the age related deposition
of calcium-salts in epithelial
basement membrane, Bowman’s
membrane & anterior stroma.
Opacity in inter-palpebral fissure
extending across the cornea.
It is removed by chelation.
15. Signs Bacterial Viral Fungal
Injection Marked moderate Marked
Follicles - + -
Ulcer Ulcer with well-defined
margins, little or no
stromal haze with
smaller stromal infiltrate
Dendritic and
geographic pattern
Smaller epithelial defect,
ulcer will ill defined
margins, greater stromal
haze with larger stromal
infiltrate, satellite
Hypopyon mobile - Dense, immobile
Depth May be deep Superficial Deep
Corneal sensation present Reduced/absent Present
Pre-auricular
lymphadenopathy
+ + -