•Bilateral lipid degeneration of the cornea.
•Two forms: Primary & Secondary. Occurs mainly in secondary form.
•May be peripheral/ central / diffuse.
ETIOLOGY:
•Accumulation of lipids may result from excessive production, impaired lipid metabolization or both mechanisms.
RISK FACTORS:
•Secondary to systemic disorders of lipid metabolism- Defects in cholesterol esterification, in lipoprotein scavenging, Fish-eye disease, Tangier disease.
•Secondary form: associated with previous ocular injury.
SYMPTOMS:
•Progressive decrease in vision.
SIGNS:
•Primary: Central lipid with cholesterol crystals severely decrease vision.
•Secondary : White/yellow stromal deposits separated by a narrow clear zone from corneal stromal neovascularisation.
•Denser than arcus.
•Appear as circular deposit at the end of long standing stromal vessels.
MANAGEMENT:
•In secondary LK, treatment should focus on the underlying disease.
•Abnormal vascularization: treated by argon laser photocoagulation or needle point cautery to induce the absorption of the lipids through the destruction of the feeder vessels.
•Intrastromal anti-VEGF agents may be an effective therapeutic option for the management of corneal neovascularization.
•Penetrating Keratoplasty.
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Image from Rajan Eye Care Hospital