𝐊𝐚𝐲𝐬𝐞𝐫–𝐅𝐥𝐞𝐢𝐬𝐜𝐡𝐞𝐫 𝐨𝐫 𝐊𝐅 𝐫𝐢𝐧𝐠𝐬 are caused by deposition of excess copper on the inner surface of the cornea in the Descemet membrane extending to the trabecular meshwork. They are usually bilateral.
These rings are seen in most of the patients with neurologic involvement from WILSON DISEASE.
However they are not specific to Wilson disease alone, they are also seen in other chronic cholestatic disorders such as primary biliary cholangitis, children with neonatal cholestasis, neonatal hepatitis, primary biliary cirrhosis, intraocular foreign body containing copper etc
The KF ring starts at the Schwalbe’s line extending rarely more than 5 mm centrally and gradually fading towards the centre of the cornea. They occur first in the superior part of the cornea.
The copper is present throughout the cornea but due to aqueous streaming, copper tends to accumulate superiorly and inferiorly, before involving the cornea circumferentially.
Early KF rings can be first seen on GONIOSCOPY before they are visible on slit lamp examination.
Image from Rajan Eye Care Hospital