![]() "Some patients with pellucid can have severe thinning, usually inferiorly, within a couple of millimeters of the limbus. "However, where keratoconus tends to mean central or paracentral thinning, pellucid is peripheral," he says. This is a cousin to keratoconus, says Wills Eye Institute corneal specialist Christopher Rapuano. However, the hallmark signs of furrow degeneration are that the thinning, if it's present at all, is very shallow, non-progressive and isn't visually significant the eye is white and quiet, there's no vascularization and there's no possibility for perforation." As for management, physicians say furrows only need to be monitored at the patient's normal office visits, and no actual treatment is necessary. "It can sometimes be illusory because the arcus is there to thicken up the cornea," says Deepinder Dhaliwal, MD, director of cornea and external disease at the University of Pittsburgh Medical Center. This is a variety of peripheral thinning, typically between the limbus and the arcus senilis, that usually occurs in elderly patients. "If necessary, you can perform a temporary tarsorraphy." "In this case, the treatment is lubrication, maybe punctal occlusion, and a bandage contact lens," he says. In the absence of inflammation, one of the more likely causes of the thinning is a dell, or an area of non-wetting that thins and then breaks down, observes Sadeer Hannush, MD, a corneal specialist and attending surgeon at the Wills Eye Institute. ![]() If it's not, ophthalmologists say you can then look for the following causes: When a patient presents with some thinning in his corneal periphery, one of the first questions physicians ask is whether or not the eye is inflamed. In this article, corneal specialists explain how you can determine the cause of a patient's thinning peripheral cornea and start the proper treatment as quickly as possible. Possible causes abound, from autoimmune disease to staph hypersensitivity ulcers, and it's up to the ophthalmologist to sort them out and come up with the right one. The "bell" sign on the PM is a deferential diagnostic sign in PMD.Everyone likes a good mystery, except when it involves finding the cause of peripheral corneal thinning. Cone location does not relate to diagnosis. The claw pattern on the ASM is not a hallmark of PMD it can be seen in PLK. In group 2, the AEM in the BFS mode revealed the kissing birds sign in 2 eyes (18.2%), and the cone was central in 1 eye (9.1%), paracentral in 8 eyes (72.7%) and peripheral in 2 eyes (18.2%). PM showed the bell sign in 4 eyes (100%). In group 1, the AEM in the best fit sphere (BFS) mode revealed no kissing birds sign, and the cone was central in 1 eye (25%) and paracentral in 3 eyes (75%). The ASM, anterior elevation map (AEM) and PM were analyzed and compared to study the "kissing birds" sign, the "bell" sign, and cone location. Patients were studied using slitlamp biomicroscopy and Scheimpflug-based tomography (Pentacam HR). Patients were distributed into two groups: (1) 4 eyes were considered PMD since they had inferior corneal thinning on both slitlamp biomicroscopy and PM (2) 11 eyes were considered as PLK since they did not show inferior corneal thinning. Clinical and tomographic findings of 15 eyes (9 patients) that had the claw pattern of the anterior sagital map (ASM) were reviewed. To study the tomographic features of pellucid-like keratoconus (PLK), and to report a new sign on the pachymetry map (PM) in pellucid marginal degeneration (PMD).Ī retrospective descriptive case series was performed in Damascus University in 2011.
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