Keratopathy

Keratopathy 

Keratopathy is a term that refers to a group of diseases of the cornea with a vast array of underlying causes and mechanisms

Types

Following are the types of keratopathy and their characteristics:

Exposure keratopathy: It is damage to the cornea that occurs primarily from prolonged exposure of the ocular surface to the outside environment. It can lead to ulceration, microbial keratitis, and permanent vision loss from scarring

Calcific band keratopathy: It is a corneal degeneration that is most often composed of calcium phosphate deposits in the superficial cornea

Band keratopathy: It is a disease of the cornea that causes calcium deposits in some layers of the cornea. It can be caused by an underlying condition, such as chronic kidney disease or hypercalcemia

Superficial punctate keratitis: It is a type of keratopathy that causes damage to small pockets of epithelial cells. It is commonly seen in corneal inflammation

Metabolic keratopathy: It is caused by the abnormal accumulation of proteins, carbohydrates, or fats in the cornea due to a wide array of metabolic disorders

Neurotrophic keratopathy: It is a disease of the cornea caused by decreased corneal nerve function

Causes 

Here are some causes of keratopathy:

Exposure to the outside environment for a prolonged period of time can cause exposure keratopathy.

• Metabolic disorders can cause metabolic keratopathy.
• Inflammation of the cornea can cause superficial punctate keratitis.
• Calcium deposits in the cornea can cause band-shaped keratopathy and calcific band keratopathy.
• Infectious or non-infectious causes can lead to neurotrophic keratitis.
• Keratitis, which is inflammation of the cornea, can be caused by various factors such as infections, exposure to ultraviolet light, vitamin A deficiency, and eyelid disorders.
• Endothelial compromise and associated corneal edema may also result in calcium deposition and band keratopathy.

The causes of keratopathy can be local or systemic, and each type of keratopathy is associated with different clinical scenarios.

Symptoms 

Signs and symptoms of keratopathy include:

• Eye redness.
• Eye pain.
• Excess tears or other discharge from your eye.
• Difficulty opening your eyelid because of pain or irritation.
• Blurred vision.
• Decreased vision.
• Sensitivity to light, called photophobia.
• A feeling that something is in your eye.
• Eye discomfort/irritation.
• Pruritus.
• Minor blurring of vision.
• Conjunctival injection.
• Conjunctival chemosis.
• Watery discharge and epiphora.
• Bilateral burning, irritation, foreign body sensation.

Diagnosis

The diagnosis of keratopathy depends on the underlying cause and the clinical scenario associated with it.

• Eye exam conducted by an ophthalmologist or optometrist.
• Keratometry, which involves focusing a circle of light on your cornea and measuring the reflection to determine the basic shape of your cornea.
• Computerized corneal mapping, such as corneal tomography and corneal topography, which record images to create a detailed shape map of your cornea.
• Corneal tomography, which can also measure the thickness of your cornea and detect early signs of keratoconus.
• Slit-lamp examination, which involves directing a beam of light onto the eye to examine the cornea and other structures of the eye.
• Specular microscopy, which is a non-invasive imaging technique that provides high-resolution images of the corneal endothelium.
• Confocal microscopy, which is a non-invasive imaging technique that provides high-resolution images of the cornea.
• Ultrasound biomicroscopy, which is a non-invasive imaging technique that provides high-resolution images of the anterior segment of the eye.