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Lipid Keratopathy

•Bilateral lipid degeneration of the cornea.

•Two forms: Primary & Secondary. Occurs mainly in secondary form.

•May be peripheral/ central / diffuse.


•Accumulation of lipids may result from excessive production, impaired lipid metabolization or both mechanisms.


•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.


•Progressive decrease in vision.


•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.


•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.⁣

Image from Rajan Eye Care Hospital⁣

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