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   Table of Contents      
ARTICLE
Year : 1980  |  Volume : 28  |  Issue : 2  |  Page : 57-60

Documentation of corneal disorders


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
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Source of Support: None, Conflict of Interest: None


PMID: 7216347

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How to cite this article:
Mohan M, Mukherjee G, Angra S K. Documentation of corneal disorders. Indian J Ophthalmol 1980;28:57-60

How to cite this URL:
Mohan M, Mukherjee G, Angra S K. Documentation of corneal disorders. Indian J Ophthalmol [serial online] 1980 [cited 2020 Nov 24];28:57-60. Available from: https://www.ijo.in/text.asp?1980/28/2/57/28222

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 Top


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 Top


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 Top


Easy Schematic documentation and quanti­fication of the corneal disorders is presented.

 
  References Top

1.
Bron, A.J., 1973, Brit. J. Ophthalmol, 57:629.  Back to cited text no. 1
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]



 

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