Posts tagged cornea

Keratoconus
Keratoconus (also known as “conical cornea”) is a degenerative disease of the eyes that manifests itself as a gradual degradation of the cornea into a more conical form than the typical eyeball. 
This condition can cause extreme nighttime vision distortion, sensitivity to light, itching, “ghost” images and some distortion of daytime vision. The etiology of this condition is not fully understood, though it’s known that proteases break down many of the keratin bonds in Bowman’s layer of the cornea, causing a relaxation of the tissues. 
In most patients with keratocornea, the degradation will “settle” at a degree that can be corrected by glasses. In 25% of patients, however, corneal transplant may be called for, in order to allow nighttime vision and increased sight during the day.
Diseases of the Eye: Number One. Moorfields Manchester Institute of Ophthalmology, The Medical Illustration Department, pre-1950.

Keratoconus

Keratoconus (also known as “conical cornea”) is a degenerative disease of the eyes that manifests itself as a gradual degradation of the cornea into a more conical form than the typical eyeball.

This condition can cause extreme nighttime vision distortion, sensitivity to light, itching, “ghost” images and some distortion of daytime vision. The etiology of this condition is not fully understood, though it’s known that proteases break down many of the keratin bonds in Bowman’s layer of the cornea, causing a relaxation of the tissues.

In most patients with keratocornea, the degradation will “settle” at a degree that can be corrected by glasses. In 25% of patients, however, corneal transplant may be called for, in order to allow nighttime vision and increased sight during the day.

Diseases of the Eye: Number One. Moorfields Manchester Institute of Ophthalmology, The Medical Illustration Department, pre-1950.

Healing process of moderate-severe mustard gas burn to eyes

Casualty caused by bursting of “Yellow Cross” shell close to man, while he was riding a resistive mule, causing his box respirator to become momentarily displaced. Fine spray of liquid splashed lightly on right side, causing cutaneous blisters on right cheek, neck, forehead, and serious burning in right eye. Left eye showed only mild burning, with a short-term acute conjunctivitis.

In similar cases, infiltrated corneal ulcer with hypopyon and secondary infection are both serious concerns. This case healed slowly but unremarkably.

Plate XIa: Severely burned eye in the acute stage - Early second day after mustard gas exposure. Eyelids and external surface of globe display intense inflammation, tears constantly produced behind edematous eyelids. Photophobia and blepharospasm at this point make examination difficult.

Plate XIb: Slightly later stage in acute burning - Swelling in conjunctiva and below has subsided, but solid white edema in the palpebral aperature is still well marked. The cornea is grey in the exposed region.

Plate XIIa: Stage of resolution after severe burning - Vascular injection is passing off, and solid edema is becoming absorbed. Corneal epithelium no longer cloudy. At this stage, atropine should be discontinued, but dark shades should be continued.

Plate XIIb: Late stage of resolution - Vascular injection above and below cornea practically disappeared, and the solid white edema is reabsorbed. The formerly red parts of the eye are now white, and the formerly white part of the eye is now red. Atropine and dark shades should not be used at this stage (which is also similar to mild burns), and use of eyes should be encouraged, with occupation (such as knitting, transcription, etc).

An Atlas of Gas Poisoning. Medical Research Council [Canada], 1918.

Ectropion and cicatrix effects.
Fig 1. Ectropion after cicatrix formation from burn healing; allowed upper eyelid to close.
Fig 2. Corrective surgery performed on Fig 1.
Fig 3. Resultant ectropion and iris/cornea deformation after healing of chemical burns caused by concentrated sulfuric acid.
Fig 4. Central figure with ectropic eye “closed”. Mucous membranes of eyelid exposed to air.
Fig 5. Cicatrix of right side of face, causing lower lid of eye to remain ectropic.
Iconographie Ophthalmologique ou Description, avec Figures Coloriees, des Maladies de l’Organe de la Vue, comprenant l’Anatomie Pathologique, la Pathologie, et la Therapeutique Medico-Chiurgicals. J. Sichel, 1859.

Ectropion and cicatrix effects.

Fig 1. Ectropion after cicatrix formation from burn healing; allowed upper eyelid to close.

Fig 2. Corrective surgery performed on Fig 1.

Fig 3. Resultant ectropion and iris/cornea deformation after healing of chemical burns caused by concentrated sulfuric acid.

Fig 4. Central figure with ectropic eye “closed”. Mucous membranes of eyelid exposed to air.

Fig 5. Cicatrix of right side of face, causing lower lid of eye to remain ectropic.

Iconographie Ophthalmologique ou Description, avec Figures Coloriees, des Maladies de l’Organe de la Vue, comprenant l’Anatomie Pathologique, la Pathologie, et la Therapeutique Medico-Chiurgicals. J. Sichel, 1859.

"Morbi corneae et sclereticae."
Ball Ophthalmology Collection at the National Museum of Medicine

"Morbi corneae et sclereticae."

Ball Ophthalmology Collection at the National Museum of Medicine

Lupus vulgaris with corneal leucoma, from 1860s

Lupus vulgaris with corneal leucoma, from 1860s