14 peri corn thin & ulcer
-
Upload
mohamad-jeffrey-ismail -
Category
Presentations & Public Speaking
-
view
8 -
download
0
Transcript of 14 peri corn thin & ulcer
![Page 1: 14 peri corn thin & ulcer](https://reader036.fdocuments.us/reader036/viewer/2022091122/589e8f881a28ab443e8b6ccd/html5/thumbnails/1.jpg)
PERIPHERAL CORNEAL THINNINGAND ULCERATION
1. Without systemic disease• Dellen• Terrien marginal degeneration• Mooren ulcer
2. With systemic disease• Rheumatoid arthritis• Wegener granulomatosis• Polyarteritis nodosa
![Page 2: 14 peri corn thin & ulcer](https://reader036.fdocuments.us/reader036/viewer/2022091122/589e8f881a28ab443e8b6ccd/html5/thumbnails/2.jpg)
Dellen
• Saucer-like thinning with intact epithelium• Fluorescein pooling but no staining
• Causes - chemosis, raised limbal lesions, abnormal blinking
Treatment - lubricants and elimination of cause
Signs Causes
• Common and unilateral• Innocuous
![Page 3: 14 peri corn thin & ulcer](https://reader036.fdocuments.us/reader036/viewer/2022091122/589e8f881a28ab443e8b6ccd/html5/thumbnails/3.jpg)
Terrien marginal degeneration• Uncommon, bilateral but asymmetrical• Initially asymptomatic
• Fine stromal lipid deposition separated by clear zone• Mild thinning and vascularization
• Circumferential thinning and increasing astigmatism• Formation of pseudo-pterygia if longstanding
Progression
Treatment of severe astigmatism - crescent-shaped excision of gutter
![Page 4: 14 peri corn thin & ulcer](https://reader036.fdocuments.us/reader036/viewer/2022091122/589e8f881a28ab443e8b6ccd/html5/thumbnails/4.jpg)
Mooren ulcer• Limited form - usually unilateral, affects elderly• Progressive form - bilateral, affects younger patients
Peripheral ulcerative keratitis Circumferential and central spread
Progression
End-stage scarring and vascularization
Treatment - systemic steroids and/or cytotoxic drugs
![Page 5: 14 peri corn thin & ulcer](https://reader036.fdocuments.us/reader036/viewer/2022091122/589e8f881a28ab443e8b6ccd/html5/thumbnails/5.jpg)
Peripheral corneal involvement in rheumatoid arthritis
• Chronic and asymptomatic• Circumferential thinning with intact epithelium (‘contact lens cornea’)
• Acute and painful• Circumferential ulceration and infiltration
Treatment - systemic steroids and/or cytotoxic drugs
Without inflammation With inflammation
![Page 6: 14 peri corn thin & ulcer](https://reader036.fdocuments.us/reader036/viewer/2022091122/589e8f881a28ab443e8b6ccd/html5/thumbnails/6.jpg)
Peripheral corneal involvement in Wegener granulomatosis and polyarteritis nodosa
Circumferential and central ulceration similar to Mooren ulcer
Unlike Mooren ulcer sclera may alsobecome involved
Treatment - systemic steroids and cyclophosphamide