|Year : 1969 | Volume
| Issue : 2 | Page : 67-68
Secondary band-shaped keratopathy
DK Sen, Hari Mohan, DK Gupta
Department of Ophthalmology, Irwin Hospital, New Delhi -1, India
|Date of Web Publication||8-Jan-2008|
D K Sen
Department of Ophthalmology, Irwin Hospital, New Delhi -1
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sen D K, Mohan H, Gupta D K. Secondary band-shaped keratopathy. Indian J Ophthalmol 1969;17:67-8
Band shaped opacity in the cornea first described by Dixons uncommon. The most common form is seen in old people with degenerated and usually shrunken eyes, as the result of long standing irridocyclitis. The rare group follows after severe interstitial keratitis or rheumatic iritis, but it has not been reported in cases of post-operative irridocyclitis. A case is reported where it has followed irridocyclitis after needling operation for congenital cataract.
| Case report|| |
S.M., Hindu, girl aged 14 years attended the Eve O.P.D. of Irwin Hospital, New Delhi for defective sight in the left eye. On questioning it was found that her left eye was operated at the age of 10 years for opaque lens which she had since birth. The eye remained irritable for some time and took 6 months to settle down. A few months later, she noted a small opacity in the "black of the eye" near the temporal periphery; then another one appeared after some time near the nasal periphery. Slowly the opacities spread towards the centre until the two sides met. On questioning her parents it was found that she had not suffered from any systemic illness of importance in childhood. There was nothing in the past history to suggest that the girl ever suffered from rheumatism.
Right eye: Vision 6/6, N 5. The eye was normal in all respects.
Left eye: Vision was reduced to perception of light with good projection. There was concomitant divergent squint of 20°. Adnexa were normal. A slightly curved grey band with concavity upwards was stretching across the exposed part of the cornea in the palpebral aperture below the middle of the pupil. [Figure - 1]. The grey opacity was separated from the limbus by a small clear zone on the nasal side but on the temporal side it merged with the scar caused by the passage of needle during the needling operation. Corneal sensation was normal. On slit lamp examination epithelium was intact and appeared to be thickened in the affected area. The epithelial surface over this area was finely stippled. The opacity was situated beneath the epithelium and extended deeper involving the superficial layers of substantia propria [Figure - 2]. The involvement was more deep in the periphery as compared to the central portion. The endothelium was normal. There were a few fine deposits of iris pigment on the back of the cornea. No flare was present.
Iris pattern was disturbed with the pupillary margin adherent to the lens capsule at places.
The pupillary area was fairly clear of lens matter. Fundus was hypermetropic but otherwise normal, as far as could be seen through a small pupil. Ocular tension was 16 mm Hg (Schiotz). The case was also examined and investigated by the physicians and found to be healthy in all other respects.
| Comments|| |
Etiology of this condition is multiple. The pathogenesis is not fully understood but has long been assumed to be of a degenerative nature. The secondary types are probably due to corneal damage and Loewenstein suggested that since Bowman's membrane had the most sluggish metabolism of the corneal tissues, an alkalosis in this region would lead to deposition of calcium phosphate. Presumably in uveitis more calcium, both protein-bound and ionized, diffuses into the cornea from damaged or dilated capillaries. The location of the deposit to the interpalpebral area has generally been ascribed to the effect of irritation and drying of the exposed part of the cornea.
Though it is seen in a diversity of conditions, it has not been reported to follow post-operative irridocyclitis. The literature was extensively reviewed by Bonnet.
| Summary|| |
A case of secondary band-shaped keratopathy following post-operative irridocyclitis after needling operation for congenital cataract is reported.
| References|| |
BONNET, P.: Band-shaped opacity of Cornea - Critical review (In French) Arch. d'Ophth. 16: 12-43.. (1956).
DIXON (1948) Quoted by Duke-Elder, system of ophthelmology vol. 3 p. 893, Henry Kimpton, London.
DUKE-ELDER (1965): System of Opht'nalmology, Vol. 8, p. 893. Henry Kimpton, London.
LOWENSTEIN Brit. J. Ophthal. 30: 317. (1946).
[Figure - 1], [Figure - 2]