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Dimples of the cornea!

𝘋𝘦𝘭𝘭𝘦𝘯⁣ ⁣ ● Fuchs described them as saucer like excavations at the periphery of the cornea⁣ ⁣ ● Clearly-defined excavations⁣ ⁣ ● Temporal side usually⁣ ⁣ ● Forming ellipses parallel to the limbus⁣ ⁣ ● Paralimbal elevation → localised break in the precorneal oily tear film → localised dehydration and thinning⁣ ⁣ ● Focal absence of mucin layer → cornea epithelium is hydrophobic and in absence of mucin will repel water and produce a dry spot → dry epithelial surface → local deturgescence of underlying anterior stroma → overlying epithelium erodes→ defect created⁣ ⁣ ● Fluorescein pools in the depression and at times there is overlying staining⁣ ⁣ ● Epithelium within the dellen can either be clear or opaque in appearance⁣

⁣ 𝘊𝘢𝘶𝘴𝘦𝘴:⁣ ⁣ 1. Following limbal elevation (episcleritis, scleritis, angioma, thick pingecula, pterygium, subconjunctival injections, filtering blebs, suture granuloma, limbal tumours)⁣ 2. After cataract surgery/ strabismus surgery⁣ 3. Rigid contact lens wear⁣ 4. Following paralytic lagophthalmos⁣ 5. Spontaneously in elderly persons⁣ ⁣ Treatment involves reduction of the paralimbal elevation and re-establishment of the mucin layer and a hydrophilic surface- Frequent lubrication, Bandage contact lenses, tarsorrhaphy.⁣ ⁣ Image from Rajan Eye Care Hospital⁣ #ophthalmology #ophthal #cornea #dellen #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency

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