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