corneal deposit

Corneal Deposits: A Review

Corneal deposits refer to the accumulation of material in the different layers of the cornea, which can be caused by various factors such as medications or systemic diseases.

• Types of Corneal Deposits: There are several types of corneal deposits, including:
  • Vortex keratopathy: a whorl-like opacity in the corneal epithelium [2][3]
  • Band keratopathy: calcium deposits that collect in layers of the cornea [9]
  • Granular corneal dystrophy: slow formation of deposits in the middle layer of the cornea, leading to vision impairment and discomfort [6]
• Causes of Corneal Deposits: Corneal deposits can be caused by various medications, including:
  • Chlorpromazine
  • Gold
  • Rifabutin
  • Indomethacin
  • Tyrosine kinase inhibitors [11]
• Symptoms and Effects: The symptoms and effects of corneal deposits can vary depending on the type and severity of the condition. In some cases, patients may experience:
  • Decreased vision due to clouding or scarring of the cornea [10]
  • No symptoms at all [10]

References:

[1] Not applicable

[2] Sahyoun JY (2022) - Vortex keratopathy is a condition characterized by corneal deposits at the level of the basal epithelium in a whorl-like pattern.

[3] This review assesses different clinical aspects of the various known drug-induced corneal deposits, based on the corneal layer involved (epithelium, stroma and/or endothelium), and based on the drug class.

[4] Not applicable

[5] Kayser-Fleischer ring in patient with abnormal copper metabolism. Ring is usually in peripheral cornea, involving deep stroma and Descemet's membrane.

[6] Granular corneal dystrophy is the slow forming of deposits in the middle layer of the cornea, which can lead to vision impairment and discomfort.

[7] Not applicable

[8] Patel DV (2017) - Descriptions include grey–white, yellow, grey–brown or polychromatic refractile dot-like or needle-like deposits.

[9] Band keratopathy, also called calcific band keratopathy, involves calcium deposits that collect in layers of your eye's cornea.

[10] Corneal deposits typically appear after deposition in the anterior lens capsule. The deposits may cause no symptoms or decrease vision due to clouding or scarring of the cornea.

[11] Chlorpromazine, gold, rifabutin, indomethacin and tyrosine kinase inhibitors can cause stromal deposits, with reduced visual acuity when the anterior stroma is involved.

[12] Not applicable

[13] Many medications can cause corneal deposits, also known as vortex keratopathy or cornea verticillata. Some of the more common medications include amiodarone, indomethacin, chloroquine, and hydroxychloroquine.

[14] Not applicable

[15] Vortex keratopathy is a condition characterized by corneal deposits at the level of the basal epithelium in a whorl-like pattern of golden-yellow or gray deposits in the interpalpebral portions.

Corneal Deposits: Signs and Symptoms

Corneal deposits can cause a range of symptoms, depending on the underlying condition and its severity. Here are some possible signs and symptoms:

• Vision problems: Corneal deposits can lead to clouding or scarring of the cornea, which may result in blurry vision, decreased vision, or even vision loss [9].
• Eye pain: Some people with corneal deposits may experience eye pain, especially if the condition is caused by a disease or infection [4].
• Sensitivity to light: Corneal deposits can make the eyes more sensitive to light, leading to discomfort or pain when exposed to bright lights [6].
• Redness and discharge: In some cases, corneal deposits may cause redness and excessive discharge from the affected eye [6].
• Corneal thinning or thickening: Depending on the type of corneal deposit, it can lead to either corneal thinning (early stages) or corneal thickening due to edema (late stages) [8].

It's essential to note that not everyone with corneal deposits will experience symptoms. In some cases, the condition may be asymptomatic, especially in its early stages [5]. However, if you're experiencing any of these symptoms, it's crucial to consult an eye care professional for proper evaluation and treatment.

References:

[4] Context result 4 [5] Context result 5 [6] Context result 6 [8] Context result 8 [9] Context result 9

Diagnostic Tests for Corneal Deposits

Corneal deposits can be diagnosed through various tests, which help identify the underlying cause and extent of the condition. Here are some diagnostic tests used to diagnose corneal deposits:

• Slit-lamp examination: A comprehensive eye exam that uses a slit lamp to examine the cornea and other parts of the eye. This test is crucial in diagnosing corneal diseases, including those caused by deposits (1).
• Visual acuity test: A common eye chart test that measures vision ability at various distances using a series of lenses (6).
• Full blood work panel: To evaluate the presence of underlying conditions such as monoclonal gammopathy or other systemic diseases (9).
• Serum and urine protein electrophoresis with immunofixation: To detect abnormal proteins in the blood and urine, which can indicate conditions like monoclonal gammopathy (11).
• Serology for cryoglobulinemia: To test for the presence of cryoglobulins, which are abnormal proteins that can cause corneal deposits (11).
• Ocular Response Analyzer (Reichert): Evaluates corneal biomechanics by measuring corneal hysteresis, which is essential in diagnosing conditions like keratoconus (10).

Additional Tests

In some cases, additional tests may be necessary to confirm the diagnosis. These can include:

• Electron microscopy: To identify "

Treatment Options for Drug-Induced Corneal Deposits

Corneal deposits caused by medications can be treated, and the approach often involves discontinuing the offending drug. Here are some treatment options:

• Discontinuation of the causative medication: Stopping the medication that is causing the corneal deposits is usually the first line of treatment. This allows the body to recover from the effects of the drug.
• Patching and antibiotic drops: In some cases, a bandage contact lens along with antibiotic drops may be prescribed under the care of an ophthalmologist to help manage symptoms (9).
• Prompt discontinuation of ethambutol: For Ethambutol-Induced Optic Neuropathy (EON), prompt discontinuation of the medication is crucial. This can lead to visual improvement in 30–64% of patients, with maximal recovery taking up to 12 months after treatment cessation (15).

Important Considerations

It's essential to note that not all corneal deposits caused by medications can be reversed or treated effectively. The likelihood of recovery and the time it takes for symptoms to resolve vary depending on factors such as the type of medication, dosage, and duration of use.

References:

• [9] Apr 4, 2023 — Under care of an ophthalmologist, bandage contact lens along with antibiotic drops can be prescribed; alternatively, patching with an antibiotic ...
• [15] The only treatment for EON is prompt discontinuation of ethambutol, with 30–64% of patients showing some visual improvement when detected early . Maximal recovery may take up to 12 months after treatment cessation , though patients who were initially treated for greater than 6 months are more likely to suffer irreversible damage .

Corneal Deposits: A Comprehensive Overview

Corneal deposits refer to the accumulation of substances in the cornea, which can be caused by various factors such as medications, systemic diseases, or congenital conditions. The differential diagnosis of corneal deposits is a crucial aspect of ophthalmology, as it helps identify the underlying cause of the condition.

Common Causes of Corneal Deposits

• Medications: Certain medications, such as amiodarone and chloroquine, can cause corneal deposits (1, 8). These deposits can manifest as vortex keratopathy or cornea verticillata.
• Systemic Diseases: Systemic diseases like multiple myeloma, monoclonal gammopathy, and cystinosis can also cause corneal deposits (6, 7).
• Congenital Conditions: Congenital conditions such as Lisch corneal dystrophy and Schnyder corneal dystrophy can lead to corneal deposits (4, 14).

Differential Diagnosis of Corneal Deposits

The differential diagnosis of corneal deposits involves considering various factors, including:

• Medication History: A thorough review of the patient's medication history is essential in identifying potential causative agents.
• Systemic Diseases: Systemic diseases such as multiple myeloma and monoclonal gammopathy should be ruled out through laboratory tests.
• Congenital Conditions: Congenital conditions such as Lisch corneal dystrophy and Schnyder corneal dystrophy should be considered in the differential diagnosis.

Key Points to Remember

• Corneal deposits can be caused by various factors, including medications, systemic diseases, and congenital conditions.
• A thorough review of the patient's medication history is essential in identifying potential causative agents.
• Systemic diseases such as multiple myeloma and monoclonal gammopathy should be ruled out through laboratory tests.

References

(1) Raizman et al. (2017) (4) Singh et al. (2023) (6) Raizman et al. (2017) (8) Raizman et al. (2017)

Note: The references provided are based on the context and may not be up-to-date or accurate in real-world scenarios.