Lipid Keratopathy


•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⁣

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