Krukenberg's spindle

Last updated
Krukenberg's spindle
Cornea showing Krukenberg's Spindle.jpg
Slit lamp photograph showing Krukenberg's Spindle as pigment cell deposits on the cornea
Specialty Ophthalmology

Krukenberg's spindle is the name given to the pattern formed on the inner surface of the cornea by pigmented iris cells that are shed during the mechanical rubbing of posterior pigment layer of the iris with the zonules that are deposited as a result of the currents of the aqueous humor. The sign was described in 1899 by Friedrich Ernst Krukenberg (1871-1946), who was a German pathologist specialising in ophthalmology. [1]

Contents

Diagnosis

Differential diagnosis

Iritis

  • Painful red eye with photophobia associated with inflammation

Vortex keratopathy

Corneal guttata

  • Non-transparent collagen deposits appearing following loss of corneal endothelial cells [3]

See also

Related Research Articles

Keratoconus

Keratoconus (KC) is a disorder of the eye which results in progressive thinning of the cornea. This may result in blurry vision, double vision, nearsightedness, irregular astigmatism, and light sensitivity leading to poor quality-of-life. Usually both eyes are affected. In more severe cases a scarring or a circle may be seen within the cornea.

Cornea

The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea accounting for approximately two-thirds of the eye's total optical power. In humans, the refractive power of the cornea is approximately 43 dioptres. The cornea can be reshaped by surgical procedures such as LASIK.

Pterygium (conjunctiva) A pinkish, triangular tissue growth on the cornea of the eye

A pterygium is a pinkish, triangular tissue growth on the cornea of the eye. It typically starts on the cornea near the nose. It may slowly grow but rarely grows so large that it covers the pupil and impairs vision. Often both eyes are involved.

Heterochromia iridum Difference in coloration, usually of the iris but also of hair or skin

Heterochromia is a variation in coloration. The term is most often used to describe color differences of the iris, but can also be applied to color variation of hair or skin. Heterochromia is determined by the production, delivery, and concentration of melanin. It may be inherited, or caused by genetic mosaicism, chimerism, disease, or injury. It occurs in humans and certain breeds of domesticated animals.

Phakic intraocular lens

A phakic intraocular lens (PIOL) is a special kind of intraocular lens that is implanted surgically into the eye to correct myopia (nearsightedness). It is called "phakic" because the eye's natural lens is left untouched. Intraocular lenses that are implanted into eyes after the eye's natural lens has been removed during cataract surgery are known as pseudophakic.

Corneal endothelium

The corneal endothelium is a single layer of endothelial cells on the inner surface of the cornea. It faces the chamber formed between the cornea and the iris.

Uveitis Inflammation of the uvea

Uveitis is the inflammation of the uvea, the pigmented layer that lies between the inner retina and the outer fibrous layer composed of the sclera and cornea. The uvea consists of the middle layer of pigmented vascular structures of the eye and includes the iris, ciliary body, and choroid. Uveitis is an ophthalmic emergency and requires a thorough examination by an ophthalmologist or optometrist and urgent treatment to control the inflammation. It is often associated with other ocular problems.

Red eye (medicine)

A red eye is an eye that appears red due to illness or injury. It is usually injection and prominence of the superficial blood vessels of the conjunctiva, which may be caused by disorders of these or adjacent structures. Conjunctivitis and subconjunctival hemorrhage are two of the less serious but more common causes.

Fuchs dystrophy

Fuchs dystrophy, also referred to as Fuchs corneal endothelial dystrophy (FCED) and Fuchs endothelial dystrophy (FED), is a slowly progressing corneal dystrophy that usually affects both eyes and is slightly more common in women than in men. Although early signs of Fuchs dystrophy are sometimes seen in people in their 30s and 40s, the disease rarely affects vision until people reach their 50s and 60s.

Arcus senilis

Arcus senilis is a depositing of phospholipid and cholesterol in the peripheral cornea in patients over the age of 60 which appears as a hazy white, grey, or blue opaque ring. Arcus is common and benign when it is in elderly patients. However, if arcus appears in patients less than 50 years old, it is termed "arcus juvenilis" and is associated with abnormally high cholesterol in the body with increased risks for cardiovascular disease.

Fleischer rings are pigmented rings in the peripheral cornea, resulting from iron deposition in basal epithelial cells, in the form of hemosiderin. They are usually yellowish to dark-brown, and may be complete or broken.

<i>Acanthamoeba</i> keratitis Human disease induced by a protist

Acanthamoeba keratitis is a rare disease in which amoebae of the genus Acanthamoeba invade the clear portion of the front (cornea) of the eye, and affects roughly 100 people in the United States each year. Acanthamoeba are protozoa found nearly ubiquitously in soil and water, and can cause infections of the skin, eyes, and central nervous system. Infection of the cornea by Acanthamoeba is difficult to treat with conventional medications, and Acanthamoeba keratitis (AK) may cause permanent visual impairment or blindness, due to damage to the cornea or through damage to other structures important to vision. Recently, AK has been recognized as an orphan disease and a funded project, orphan diseases Acanthamoeba keratitis (ODAK), has tested the effects of a diverse range drugs and biocides on AK.

Iridocorneal Endothelial (ICE) syndromes are a spectrum of diseases characterized by slowly progressive abnormalities of the corneal endothelium and features including corneal edema, iris distortion, and secondary angle-closure glaucoma. [1,2,4] ICE syndromes are predominantly unilateral and nonhereditary [1,2,4]. The condition occurs in predominantly middle-aged women [1,3,4].

Corneal neovascularization

Corneal neovascularization (CNV) is the in-growth of new blood vessels from the pericorneal plexus into avascular corneal tissue as a result of oxygen deprivation. Maintaining avascularity of the corneal stroma is an important aspect of corneal pathophysiology as it is required for corneal transparency and optimal vision. A decrease in corneal transparency causes visual acuity deterioration. Corneal tissue is avascular in nature and the presence of vascularization, which can be deep or superficial, is always pathologically related.

Corneal tattooing is the practice of tattooing the cornea of the human eye. Reasons for this practice include improvement of cosmetic appearance and the improvement of sight. Many different methods and procedures exist today, and there are varying opinions concerning the safety or success of this practice.

Pellucid marginal degeneration

Pellucid marginal degeneration (PMD), is a degenerative corneal condition, often confused with keratoconus. It typically presents with painless vision loss affecting both eyes. Rarely, it may cause acute vision loss with severe pain due to perforation of the cornea. It is typically characterized by a clear, bilateral thinning (ectasia) in the inferior and peripheral region of the cornea, although some cases affect only one eye. The cause of the disease remains unclear.

Meesmann corneal dystrophy

Meesmann corneal dystrophy (MECD) is a rare hereditary autosomal dominant disease that is characterized as a type of corneal dystrophy and a keratin disease. MECD is characterized by the formation of microcysts in the outermost layer of the cornea, known as the anterior corneal epithelium. The anterior corneal epithelium also becomes fragile. This usually affects both eyes rather than a single eye and worsens over time. There are two phenotypes, Meesmann corneal dystrophy 1 (MECD1) and Meesmann corneal dystrophy 2 (MECD2), which affect the genes KRT3 and KRT12, respectively. A heterozygous mutation in either of these genes will lead to a single phenotype. Many with Meesmann corneal dystrophy are asymptomatic or experience mild symptoms.

Herpes simplex keratitis

Herpetic simplex keratitis is a form of keratitis caused by recurrent herpes simplex virus (HSV) infection in the cornea.

Cornea verticillata

Cornea verticillata, also called vortex keratopathy or whorl keratopathy, is a condition characterised by corneal deposits at the level of the basal epithelium forming a faint golden-brown whorl pattern. It is seen in Fabry disease or in case of prolonged amiodarone intake.

Corneal opacity

Human cornea is a transparent membrane which allows light to pass through it. The word corneal opacification literally means loss of normal transparency of cornea. The term corneal opacity is used particularly for the loss of transparency of cornea due to scarring. Transparency of the cornea is dependent on the uniform diameter and the regular spacing and arrangement of the collagen fibrils within the stroma. Alterations in the spacing of collagen fibrils in a variety of conditions including corneal edema, scars, and macular corneal dystrophy is clinically manifested as corneal opacity. The word 'Corneal blindness' is commonly used to describe blindness due to corneal opacity.

References

  1. Krukenberg F. (1899) Beiderseitige angeborene Melanose der Hornhaut. Klin Mbl Augenheilkd 37:254-258.
  2. Chew, E; Ghosh, M; McCulloch, C (June 1982). "Amiodarone-induced cornea verticillata". Canadian Journal of Ophthalmology. 17 (3): 96–9. PMID   7116220.
  3. Akimune C, Watanabe H, Maeda N, et al. (January 2000). "Corneal guttata associated with the corneal dystrophy resulting from a betaig-h3 R124H mutation". The British Journal of Ophthalmology. 84 (1): 67–71. doi:10.1136/bjo.84.1.67. PMC   1723238 . PMID   10611102.
Classification
D