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Sclerocornea⁣





Hereditary anomaly in which scleralization involves either the peripheral cornea or entire cornea.⁣

Non progressive, bilateral, asymmetric.⁣

The opacification of cornea is smooth, white and vascularised.⁣

It is an extension of sclera without limbal landmarks and is greater peripherally than centrally.⁣

Vessels are fine continuations of conjunctival vessels.⁣

Waring & Rodrigues classification: ⁣

1) Isolated peripheral Sclerocornea⁣

Abrupt change from sclera tissue to clear corneal tissue with no other ocular abnormality⁣

2) Sclerocornea plana⁣

Flat corneas having K reading <38 D causing high hyperopia⁣

AC is shallow⁣

Pseudoptosis present due to flat cornea supporting the upper eyelid poorly⁣

3) Sclerocornea associated with anterior chamber cleavage anomalies:⁣

Has paracentral corneal adhesions. Eg. Peter’s anomaly⁣

4) Total sclerocornea⁣

Corneas are totally opaque and vascularised.⁣

Central cornea is not as densely opaque as peripheral cornea. The opacification affects the full thickness of the stroma⁣

Histopathologically, corneal stroma resembles sclera. Stromal vascularisation present.⁣

Precisely arranged stromal lamellar absent.⁣

Histopathology⁣

Vascularised stroma consists of irregularly arranged collagen lamellae.⁣

Collagen lamellae have variable diameter- increased anteriorly and decreased posteriorly (the reverse is true for normal cornea).⁣

Diagnosis⁣

UBM: for diagnosis of sclerocornea, associated structural abnormalities, to help in surgical planning.⁣

Differential Diagnosis⁣

Arcus juvenilis. Interstitial keratitis. Peter’s anomaly. Microcornea.⁣

Management:⁣

Neutralise refractive errors if any.⁣

If disorder is unilateral and other eye has good visual acuity: Surgery performed only if other ocular structures are relatively normal.⁣

If central corneas are affected bilaterally: Penetrating Keratoplasty.


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