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Prof, DR, DR Rukiah Sawal SPM (K)

The document discusses the anatomy, physiology, diseases, and treatment of the cornea. Specifically, it covers the transparent and avascular structure of the cornea, common diseases like keratitis and corneal ulcers, risk factors for conditions like bacterial corneal ulcers, and treatments which aim to address the etiology and prevent sight-threatening complications such as corneal scarring and perforation. Prompt diagnosis and treatment of serious corneal diseases is emphasized to prevent permanent visual impairment or blindness.

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37 views37 pages

Prof, DR, DR Rukiah Sawal SPM (K)

The document discusses the anatomy, physiology, diseases, and treatment of the cornea. Specifically, it covers the transparent and avascular structure of the cornea, common diseases like keratitis and corneal ulcers, risk factors for conditions like bacterial corneal ulcers, and treatments which aim to address the etiology and prevent sight-threatening complications such as corneal scarring and perforation. Prompt diagnosis and treatment of serious corneal diseases is emphasized to prevent permanent visual impairment or blindness.

Uploaded by

ULI
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Prof, DR, dr Rukiah Sawal SpM (K)

Anatomy and Physiology


 Ant part of the eye
• Transparant
• Avascular
• Refracting and Protective “ window” of
Route light rays
(MEDIA REFRACTA)
Fig .Anatomy
Fig. Histology
Transparancy
 Uniform Structure
• Avascular
• Deturgescence
Nutrition
 Perilimbal capillaries
• Air + tear film
• Aqueous humor
Innervation : N V1
Desease of the cornea
Extremely serious
Permanent visual impairment
Blindness
Prompt diagnosis and prompt treatment
Pathology
Congenital
Inflamation : Keratitis

Trauma
Tumor
Degeneration
Keratitis
 Keratitis : - Superficial
- Profunda (interstitial)
- Non ulceration
- Cornea Ulcer

Superficial : epithel and superficial stroma

Cornea ulcer: defect / discontinuity


Superficial
Fig histology
Keratitis

Ethiology :
- Infective
- Degenerative
- Allergic
- Toxic
Classification
Cornea Ulcer
1. Bacterial
2. Viral
3. Fungal
4. Hypersensitivity reaction
5. Neurothropic
6. Exposure
7. Idiopathic
Clinical Presentation
 Pain
 Photophobia
 Lacrimation
 Blepharo spasme
 Blurred vision
 Pericorneal / ciliary injection
 Infiltrate, edem, defect cornea
Bacterial Corneal Ulcer
Sight – threatening
- Progressive stromal in flurocen
- Progresive tissue destruction
- Cornea perforation
- Infection to adjacent tissue
Risk Factors
 Contact lens wear
 Trauma
 Contaminated ocular medication
 Impaired defense mechanism
 Altered structure of corneal surface
Clinical Persentation
 Pain, photophobia, blepharospasme
lacrimation, decreased vision
 Pericorneal injection – red eye
 Sharply demarcated epithelial defect
Stromal edema
Suppurative Stromal inflamation
 Ant chamber reaction : KP. Hypopyon
Viral Corneal ulcer
Clinical presentation
HSK
 Foreignbody sensation, photophobia
Lacrimation, blurred vision
 Pericornea injection / ciliary flush
 Rose bangal, fluoroscein Staining (+)
 Reduced corneal sensation
Keratitis herpes simpleks
HZ0
 Zoster dermatitis affected N V1
 Punctate or dendritic epithelial keratitis
 50% decreared corneal sensation
 Intestitial keratitis and anterior uveitis > HSK
Fungal Corneal ulcer
Rish Factor :
 Gardener : preplant or vegetable
 Contact lens wear
 Corticosteroid treatment topical / systemic
Clinical Presentation
 Resemble with batecterial ulcer
 Gray-white infiltrate, irreguler and filament margins
 Satelite infiltrate
 Anterior chamber reaction, hypopion
Hypersensitivity reaction
1. Atopic keratoconjunctivitis
2. Steven Johnson syndrome
3. Ocular cicatrical Pemphigoid
4. Mooren Ulcer
1

2 3
4
Treatment cornea ulcer
 Etiology / cause
 Predisposing factors
 Potentially sight threateming
 Local - cycloplegic : atropin 0.5%
- Specific : antibiotic, anti viral,
anti fungal,
anti inflamation /
immunosuppresive eye drop /
ointment

• Systemic : oral : IV
Subconjunctiva, subtenon
- Surgical ( complication )
Complications
1. Corneal scar : nebula, macula, leucoma
2. Iridocyclitis : Synechia, complited cataract,
secondary glaucoma
3. Perforation
4. Endofthalmitis
5. Panophthalmitis
6. Atrophia bulbi

Visual impairment – visual loss


Perforasi kornea

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