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Enigmatic corneal artifacts point to conditions that require a full range of treatment
 Ivan R. Schwab |
SAN FRANCISCO — Various ailments may cause superficial corneal spots — but not all require treatment, an expert said here.
Ivan R. Schwab, MD, shared pearls on identifying corneal artifacts and diagnosing underlying systemic disease during Cornea Day preceding the American Society of Cataract and Refractive Surgery meeting.
Conditions heralded by corneal spots and dots include Thygeson's SPK, basement membrane dystrophy and late mucous plaque keratitis of herpes zoster.
"Certainly corneal scars, trauma and such can mimic any of these [conditions] at almost any time at almost any depth," he said.
Interstitial keratitis may point to syphilis, EB virus, leprosy, sarcoidosis and tuberculosis. Those diseases must be diagnosed and may require systemic treatment, Dr. Schwab said.
Basement membrane dystrophy and mucous plaque keratitis of herpes zoster seem suitable for debridement. However, debridement in these cases may lead to non-healing epithelial lesions or neurotrophic ulcers. If lesions require treatment, low-dose steroids, cycloplegia and oral anti-viral medications may be appropriate, Dr. Schwab said.