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Corneal Dystrophies (2)

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					Corneal Dystrophies
Corneal Dystrophies
 Are group of progressive hereditary
  corneal metabolic dysfunctions that
  always lead to bilateral opacification of the
  various layers of the cornea
 Presentation – 1st and 4th decade of life
Classification
   Classified into
    ◦ Epithelial
       Epithelial basement memb (Cogan) dystrophy
       Meesman dystrophy
    ◦ Bowman layer
       CDB-1
       CDB-2
       Crystalline dystropohy
    ◦ Stromal
       Granular dystrophy (hyaline deposits)
       Lattice dystrophy (amyloid deposits)
       Macular dystrophy (deposits of acidic mucopolysaccharides)
    ◦ Endothelial
       Fuchs’ endothelial dystrophy
Symptoms & Diagnostic
considerations
   Steadily increasing loss of visual acuity
   Photophobia & watering
   Corneal opacification
   Impaired corneal sensations
   Deposits in coneal layers
   Epithelial and stromal corneal dystrophies
    are also often accompanied by painful and
    recurrent corneal erosion.
   Fuchs endothelial dystrophy involves a
    gradual loss of endothelial cells that in time leads to
    bullous keratopathy & patient typically will have
    poorer vision in the morning
Treatment
 Depending upon degree of visual loss
 May not be required at all
 5% sodium chloride drops for corneal
  edema
 Bandage Contact Lens
 Excier laser keratectomy
 Keratoplasty
    ◦ Lamellar
    ◦ Deep lamellar
    ◦ penetrating
Epithelial dystrophies
   Epithelial basement memb dystrophy
    ◦ Also known as Cogan microcytic or
     map-dot-fingerprint
    ◦ Most common
    ◦ Frequently misdiagnosed due to its variable
      appearance
    ◦ Inheritance – sporadic
    ◦ Onset – 2nd decade of life

				
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