2. Definition
Non ulcerative inflammation of corneal
stroma without primary involvement of
epithelium and endothelium.
It is mostly allergic in origin and may be
infective also.
5. Pathogenesis
T.pallidum invades & sensitizes cornea during
foetal stage
later the exposure to either treponema or its toxin
Inflammation of the sensitized cornea due to local
Ag - Ab reaction
11. Initial progressive stage
• One or more Hazy patches appear in the
deep layers of the stroma.
• Associated with uveitis ( iritis , cyclitis ,
choroiditis )
• Presence of keratic precipitates.
• Diffuse corneal haze – ground glass
appearance
• Lasts for about 2 weeks
12.
13.
14. Florid stage ( 2 months )
Deep vascularization of the cornea – radial
bundle of brush like vessels.
Salmon patch appearance due to the
haziness of cornea.
May be moderate degree of superficial
vascularization.
Vessels & conjunctiva appears heaped at
the limbus.
15.
16. Stage of regression
• Corneal haze resolves slowly & begins
from periphery towards centre.
• As cloudiness disappears , the vessels
become obliterated & they remain
permanently as fine opaque lines ( ghost
vessels ).
• Lasts for about 1 – 2 yrs.
17.
18. Diagnosis
Corneal haze & other typical findings on
slit lamp examination.
Serology
- VDRL
- T.pallidum immobilisation test
- micro haemagglutination assay
- fluorescent Ab absorption test
19. Treatment
LOCAL
- topical corticosteroid drops ( 0.1% )
every 2-3 hrs
- atrophine eye ointment 1% 2 – 3
times/day
- dark googles for photophobia
- penetrating keratoplasty
20. SYSTEMIC
- high doses of penicillin to
prevent further development of lesions
- systemic steroids can be given in
refractory cases.
21. TB INTERSTITIAL
KERATITIS
Features similar to syphilitic keratitis
except that it is frequently unilateral &
involves mostly lower sector of cornea.
Treatment
systemic - anti TB drugs
Topical - steroids & cycloplegics
22. Cogan’s syndrome
• A rare autoimmune disease of eye &
inner ear.
• Common in young adults.
• May be associated with severe vasculitis.
Features
- vertigo , tinnitus & deafness.
- bilateral (IK) , uveitis & blindness.
23.
24. Treatment
• Urgent evaluation is indicated because
early treatment prevents permanent
deafness & blindness.
• Systemic & topical corticosteroids.