Cornea slides for undergraduates.

1. Cornea slides revision
Ahmed Osama Hashem
PhD, MSc Ain Shams University
FRCS
Lecturer Ophthalmology Kafrelsheikh university.

2. Test of corneal sensation lt eye

3. (corneal abscess) with hypopyon

4. (corneal abscess) with hypopyon (Fungal)

5. (corneal abscess) with hypopyon (Fungal)
hypopyon,Feathery edges,,

6. Acanthamoeba Ring ulcer

7. Herpetic blepharitis lt lower eyelid (vesicles)

8. Dendretic ulcer Rose Bengal stain..

9. Dendretic ulcer, FL stain

10. Dendretic ulcer Rose Bengal stain..

11. Herpes Zoster ophthalmicus,, Lt
eye(ophthalmic of the trigeminal n.)

12. Lt eye Inferior Temporal limbal Foreign body

13. Post Trachomatous calcification ,,lower lid
entropion trichiasis

14. Penetrating keratoplasty interrupted sutures

15. Protruding loose stitch of PKP

16. Chemical injury , cornea vascularized and
opacified

17. Keratomalacia ,,anterior staphyloma vitamin A
deficiency,,,

18. Keratomalacia

19. Keratomalacia

20. Keratomalacia (Blind painful eye )

21. + Bitot spot,,,

22. Xerosis,, vitamin A deficiency

23. Neurotrophic ulcer

25. Medial Tarsorrhaphy

26. lagophthalmos
• Definition: inability to close the palpebral fissure

27. • Lagophthalmos lead to exposure keratopathy,
Bell’s phenomenon…,, the upper 2/3 covered by upper lid while the
ulcer affect the lower third,,,,

28. Bell’s phenomenon

29. Peripheral ulcerative keratitis,, Mooren’s ulcer
(Ischemia from peripheral vasculitis)

30. Marginal Keratitis

31. Marginal ulcer coalesce to form Ring ulcer

32. 2ry corneal ulcer

33. Trachomatous ulcer

34. Gonococcal conjunctivitis

36. Diphtheritic conjunctivitis

37. Phlyctenular ulcer

38. Phlycten

39. Hypersensitivity reaction

40. PHLYCTENULOSIS
• Predominantly affects children
• Etiology – Tuberculosis
– Delayed hypersensitivity reaction to staphylococcal or other
bacterial antigen

41. phlycten

42. • A phlyctenule (also called phlycten) is a characteristic nodular
affection occurring as an allergic response of the conjunctival and
corneal epithelium to some endogenous allergens to which they have
become sensitized.

43. PRESENTATION
• Photophobia, lacrimation and blepharospasm.

44. SIGNS
• Conjunctival: Pinkish-white nodule surrounded by hyperaemia
• Corneal: May resolve spontaneously or extend radially to the cornea.
May cause severe ulceration or perforation.

45. phlycten

46. phlycten

47. phlycten

48. Causes:
• Tuberculous protein
• Staphylococcus protein-most common
• Others- Moraxella axenfeld bacillus and certain parasites

49. • Predisposing factors:
• Age—3-15 yrs
• Under nourished
• Living conditions- over crowded and unhygienic conditions
• Season- more in spring and summer

51. Fascicular ulcer

52. • Treatment:
• local-
• -topical steroid-dexamethasone or betamethasone
• -antibiotic drops and ointment
• -atropine 1% eye ointment once daily if cornea is involved
• specific:
Tuberculosis should be excluded by Chest x-ray, mantoux test, ESR and if necessary full dose ATT
should be given.
• -Septic focus in the form of tonsillitis, adenoiditis, teeth caries should be treated by antibiotics
and necessary surgical interventions.
• -parasitic infestation should be ruled out and treated if necessary.
• General:
high protein diet and Vit. A, C, and D supplementation.

53. DD Pinguecula

54. DD,, Pterygium

55. Degenerative corneal conditions
• Arcus Senilis

56. Photophthalmia

57. KERATOCONUS
• Onset at puberty
• Central or paracentral stromal thinning
• Apical protrusion
• Irregular astigmatism
• Autosomal dominant transmission with incomplete penetrance
proposed

58. CLASSIFICATION
• By keratometry: - Mild (< 48 D),
- moderate (48-54 D) - severe (> 54 D)
• By morphology: - Nipple cones
– Oval cones – Globus cones

59. Early signs
• Ophthalmoscopy: Oil droplet reflex
• Retinoscopy: Irregular scissor reflex
• Keratometry: Irregular astigmatism (principal meridians no longer 90
degree apart and mires cannot be superimposed)
• Placido disc: Irregular reflected ring
• Slit-lamp: Very fine deep stromal striae (Vogt lines).

60. LATE SIGNS
• Decreased visual acuity
• Munson sign
• Fleischer ring
• Corneal scarring
• Acute hydrops

62. Manson’s sign

63. Iron deposition around base of the cone in
keratoconus,Fleischer ring

64. Rigid contact lens…

65. Rigid contact lens

69. Streak ,,retinoscopy

70. Acute hydrops in keratoconus

71. Oil droplet,,cone side view,,Manson sign in
keratoconus,,,