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Answers: 2004 series -  March 23, 2004 Lecture 41 of 50  NEXT»

  corneal condition  corneal condition 2

The pictures above show a severe and a mild example of the same condition.

1.  This condition is: 
  d -- Each of the above pictures shows a delle (note dellen is the plural).  These can be very obvious as a localized corneal thinning with opacity as in the left hand picture or can be subtle showing only a small depression with a clear cornea as shown on the right.  In either case, all of the corneal layers remain intact but dehydrated.

2.  Treatment for the above is:
  c -- Frequent lubricating drops and in some cases use of a patch will result in rehydration of the cornea and elimination of the delle.  Since the corneal layers remain intact, rehydration brings the cornea back to its normal state.  There is no need for steroid or antibiotic drops in these cases.  As with any ophthalmic or other medical condition, the unnecessary use of steroids and/or antibiotics should be avoided.  Although this condition tends to be self-limiting, failure to treat in a timely manner can result in prolonged discomfort for the patient and the possiblity of epithelial breakdown and secondary infection is always present.

3.  The cause of this condition is:
  a -- The cause of this condition is localized drying of the cornea which usually occurs when there is an area of heaped up conjunctiva at the limbus.  This causes improper lubrication of the adjacent cornea and therefore, localized dehydration.  Dellen occur in cases of strabismus surgery with excessive conjunctival accumulation at the limbus.  This condition is benign and is very treatable, but at the same time it is avoidable in most cases by the use of good technique.




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