corneal ectasias

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ECTATIC,KERATOCONNUS

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  • 1.ECTATIC CONDITIONS OF CORNEASATISH REDDY A.N

2. CORNEAL ECTASIAS 1. Keratoconus2. Keratoglobus3. Keratotorus (Pellucid marginal degeneration) 3. KERATOCONUS Is a non-inflammatory bilateral(85%) ectatic condition of cornea (axial part) PUBERTY (early 20s) SLOWLY PROGRESSIVE 4. ETIOPATHOGENESIS Etiology of keratoconus remains unclear Theories developmental condition, degenerative condition, hereditary dystrophy, endocrine anomaly Essential pathological changes thinning and ectasia ( defective synthesis of Mucopolysaccharide and Collagen tissue) 5. CLINICAL FEATURES SYMPTOMS Distorted and blurred vision Myopia (nearsightedness) Astigmatism Double vision Headaches due to eye strain Glare Light sensitivity 6. Signs of keratoconusPlacido disc examinationVogt striaeProminent corneal nervesBulging of lower lids on downgaze Fleischer ring & scarringMunson signAcute hydrops 7. Oil droplet reflex- Scissor reflex 8. Morphological classification of keratoconus Nipple coneOval coneSmall and steep curvatureLarger and ellipsoidalGlobus coneLargest 9. Ocular association Ectopia lentis Congenital cataract Aniridia Retinitis pigmentosa Vernal keratocongectivitis (VKC) 10. Systemic associations of keratoconusAtopic dermatitisMarfan syndromeDown syndromeCrouzon syndromeEhlers-Danlos syndromeOsteogenesis imperfecta 11. Treatment Spectacle correction Contact lenses (rigid gas permeable) Intacts intracorneal ring segmets 12. Cornecollagen cross linkingal may slow the progression of disease Keratoplasty (required in later stages ) DALK-deep anterior lamellar keratoplasty PK-penetrating keratoplasty 13. KeratoglobusOnset usually at birth (hereditary and congenital disorder) Bilateral protrusion and thinning of entire cornea Associations - Leber congenital amaurosis and blue sclera 14. Pellucid marginal degenerationOnset between 20 and 40 yearsBilateral crescent-shaped inferior corneal thinning