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| Year : 1980 | Volume
: 28
| Issue : 2 | Page : 57-60 |
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Documentation of corneal disorders
Madan Mohan, G Mukherjee, SK Angra
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi-29, India
Correspondence Address:
Madan Mohan
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, A.I .M.S. New Delhi-110029
India
PMID: 7216347
How to cite this article:
Mohan M, Mukherjee G, Angra S K. Documentation of corneal disorders. Indian J Ophthalmol 1980;28:57-60 |
Corneal involvement by disease process constitutes a major portion of all anterior segment disorders. Lack of standardised documentation poses problem which in turn has a direct impact on the management. Bron[1] has made an attempt to document some of the corneal lesions but these do not cover the spectrum of diseases seen commonly in India and other developing countries.
The following scheme for documentation of physical signs has been evolved, satisfactorily used and perfected in the Cornea Clinic at this Centre during the past decade.
 Methodology | |  |
I. Topographic Depictions
In the plan view the cornea having diameter 12mm is represented by a double circle indicating the limbus. This is divided into 36 squares. Each square represents 2m.m. square area of cornea and is labeled by alphabets horizontally and by numerical vertically. inside the limbal circle, two more circles in dots corresponding to 4 and 8 mm. in diameter of cornea, roughly correspond to the pupillary border and collarette respectively. The cornea is thus divided into central ( 4mm. as optical zone), mid peripheral and peripheral zones [Figure - 1] a. This helps in the proper localisation and quantifying the size of the lesions in the plan view.
Three slit sectional views are drawn to depict the site and the depth of the lesion [Figure - 1] b. The curvature and thickness of cornea can be denoted by drawing continuous line. Any three planes can be chosen and labeled. Changes in the anterior chamber, iris, pupil, lens etc. can be drawn in the [Figure - 1]c.
II. Abbreviation scheme
Abbreviation scheme adopted for recording lesions are as follows
A. Anatomical levels : are given in capital followed by lower case letter
Ep. = Epithelium
Bm = Bowman's membrane
St = Stroma
Dm = Descemet's membrane
En = Endothelium.
B. Physical signs : All pathological findings for labeling the diagrams are denoted in double lower case letters
as = Anterior Synechia
ab = Abscess
ar = Arcus
bs = Bitot's spots
bu = Bullae
ca = Calcification
cc = Cicatrization
ci = Corneo-Iridic
cn = Cone
dg = Degeneration
ec = Ectasia
fc = Facet
gt = Gutter
hy = Hypopyon
hp = Herbert's pits
hg = Haemorrhage.
in = Infiltration
kt = Keratitis
kp = Keratic precipitates
km = Keratomalacia
lf = limbal follicle
lc = Leucoma
la = Leucoma adherans
mc = Macula
nb = Nebula
nd = Nodule
oe = Oedema
op = Opacity
pn = Pannus
ps = Posterior synechia
pt = Pterygium.
sc = Scar
st = Staphyloma
to = Thinning
tc = Thickening
ul = Ulcer
vs = Vascularisation superficial
vd = Vascularisation Deep.
xs = Xerosis.
C. Annotations : The documentation in a schematic diagram many a time fails to give a comprehensive impression in the observers mind. Grading of signs is helpful in checking the progress of the lesion and are denoted as
( ±) Doubtful
(1+) Minimal/slight
(2+) Mild
(3+) Moderate
(4+) Severe
The scheme for drawing the lesions are shown in [Figure - 2]. Documentation of some of the important corneal disorders, as examples, are shown in the [Figure - 3][Figure - 4].
D. Scoring : For further probing into the course of the disease or follow up of clinical course, or drug action, each important sign is assigned a score on the basis of its importance and is graded accordingly. This helps in proper evaluation of results of project oriented clinical research.
| Discussion | | |
Standardised scheme for documentation of corneal disorders is essential for proper follow up of patients especially in hospitals with many doctors attending the clinics, as also from clinical research view point. Serial photographic documentation apart from being expensive, fails to depict many early lesions specially in these ocular structures. The schematic documentation of ocular disorders, when standardised and practiced, serves a as good clinical record and gives better mental picture of the disease and its progress.
The plan view of the cornea having a combination of 36 squares and 3 zones gives the opportunity to document the lesions regarding their size and distribution with precise depth localisation and quantification. The labeling of squares vertically as well as horizontally help to place the lesion accurately in the sectional view. This documentation scheme has been found handy to depict the disorders of cornea e.g. trachomatous changes, corneal ulcer, abscess, keratomalacia & various grades of corneal opacities, staphyloma, corneal degenerations and dystrophies seen commonly in the tropical and developing countries.
| Summary | | |
Easy Schematic documentation and quantification of the corneal disorders is presented.
| References | | |
| 1. | Bron, A.J., 1973, Brit. J. Ophthalmol, 57:629.  |
Figures
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]
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