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Opt 631 Exam 1 Corneal Pigmentations
Dr. Yudcovitch Lecture 1
26
Medical
Graduate
09/03/2011

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Term
This corneal pigmentation is a brownish, vertical, spindle-shaped deposition on the inferior 1/3 to 1/2 of the posterior cornea. It suggests old uveitis or pigment dispersion syndrome.
Definition
Kruckenberg's Spindle
Term
In what cell layer is Kruckenberg's Spindle located?
Definition
Corneal endothelium
Term
Kruckenberg's Spindle is one possible sign of what eye disease?
Definition
Pigmentary dispursion glaucoma
Term
This corneal pigmentation appears in a swirl pattern of greyish or golden epithelial deposits from a point below the pupil. It is seen in patients with an alpha-galactosidase A deficiency called Fabry Disease.
Definition
Vortex Keratopathy
Term
This corneal pigmentation is seen in patients being treated with a variety of drugs, including but not limited to amiodarone, hydroxychloroquine, indomethacin, and tamoxifen.
Definition
Vortex Keratopathy
Term
This corneal pigmentation is a brownish, triangular-shaped pigmentation at the 6 o'clock position on the posterior cornea. It is pathognomonic for old uveitis.
Definition
Arlt's Triangle
Term
This corneal pigmentation is a brownish, edematous haze in the corneal epithelium, progressing from the limbus into the cornea. It is pathognomonic for EBMD and RCE.
Definition
Brawny cornea
Term
This corneal pigmentation is an orangish-brown ferric deposition around a surgical filtration bleb. It carries no pathologic indication.
Definition
Ferry's Ring
Term
This corneal pigmentation is an orangish ferric deposition at the base of the keratoconic cone. It is pathognomonic for keratoconus.
Definition
Fleisher's Ring
Term
This corneal pigmentation is a brownish, horizontal line of pigment granules forming on the inferior cornea. It is pathognomonic for pigmentary glaucoma.
Definition
Goar's line
Term
This corneal pigmentation is a reddish-brown, intracorneal or posterior corneal surface blood stain. It is pathognomonic for hyphema (posterior stain) and intracorneal bleeding (neovascularization).

'Painted blood.'
Definition
Hemosiderosis
Term
This corneal pigmentation is an orangish-brown deposition at Bowman's in the area of the upper and lower lid junction. It's seen more in males and with age, and is a frequent site of RCE.
Definition
Hudson-Stahli Line
Term
This corneal pigmentation is an orangish copper deposition in the anterior angle of the posterior cornea, best seen in gonioscopy. It suggests for Wilson's hepaticolenticular disease.

(Like Arcus, but orangish in color.)
Definition
Kaiser-Fleischer Ring
Term
This disease is suggested by a Kaiser-Fleischer Ring. It presents with liver cirrhosis and basal ganglia degeneration, and is due to decreased ceruloplasmin with copper deposition into the organs.
Definition
Wilson's Disease
Term
These corneal pigmentations are white or pigmented on the endothelial surface, pathognomonic for uveitis or trauma.
Definition
KPs or Keratic Precipitates
Term
This corneal pigmentation presents with spokes radiating out into the cornea from the limbus, most frequently at 4 and 8 o'clock in heavily pigmented individuals. It is pathognomonic for trauma, infection, and focal toxic inflammation of Staph.
Definition
Keratomelanocytosis (Striate Melanokeratosis)
Term
This corneal pigmentation is an orangish discoloration of midstroma that suggests syphilitic keratitis.
Definition
Salmon Patch
Term
This corneal pigmentation presents as pigment granules at Schwalbe's line, and suggests pigmentary glaucoma.
Definition
Sampaolesi's Line
Term
This corneal pigmentation is an orangish-brown ferric deposition at a pterygium leading edge.
Definition
Stocker's Line
Term
In this syndrome, the endothelium can proliferate and migrate into the angle and onto the iris surface, causing synechial angle closure leading to glaucoma.

What's it called, what demographic is more prone to contracting it, unilateral or bilateral, what what three overlapping disorders does it consist of?
Definition
ICE Syndrome
females
unilateral
1st, Chandler syndrome
2nd, Cogan-Reese syndrome
3rd, Progressive Iris Atrophy (yikes.)
Term
ICE Syndrome stands for what?
Definition
Iridocorneal Endothelial Syndrome
Term
Corectopia (malposition of the pupil), pseudopolycoria (multiple "pupils") in a previously normal iris, iris atrophy, and corneal endothelial abnormalities are objective findings in what syndrome?
Definition
ICE Syndrome
Term
This syndrome has corneal endothelial abnormalities that present a hammered appearance similar to Fuch's and corneal edema due to endothelial defects.

Name the syndrome and the technique that offers the best view of these corneal endothelial abnormalities.
Definition
ICE Syndrome, specular reflection
Term
This syndrome presents with severe corneal changes, corneal edema, and a normal or mildly atrophied iris.
Definition
Chandler Syndrome
Term
This syndrome presents with diffuse nevi (or iris nodules), a matted-looking iris surface, and iris atrophy in about 50% of those afflicted.
Definition
Cogan-Reese Syndrome
Term
This syndrome presents with severe iris changes, iris stromal atrophy, iris hole formation, and pupil displacement towards the area of synechiae.
Definition
Progressive Iris Atrophy
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