Oil droplets!

Oil droplets!⁣

Spheroidal degeneration⁣




Degeneration of cornea/conjunctiva⁣

Homogeneous,translucent,fine,golden yellow spherules/globules of varying size⁣

Aka Climatic droplet keratopathy/ Actinic keratopathy/Bietti’s band-shaped⁣

nodular dystrophy/ Labrador Keratopathy⁣

Risk factors⁣

Old age, UV light (Most common), dry eyes, malnutrition,Corneal trauma from wind, sand, low humidity & extreme temperatures, Welding burns⁣

Pathology⁣

Light microscopy:extracellular deposits in different sizes & shapes, such as spherical, elongated, or angular, in subepithelium, Bowman membrane, & superficial stroma of cornea⁣

Epithelium & basement membrane are affected only in advanced stages, during which Bowman's membrane is often disrupted or absent locally⁣

Light microscopy:lesions stain blue-green with toluidine blue, bright red with methyl green-pyronin,variable pink with Gomori’s aldehyde fuchsin (demonstrates collagenous component),stains eosinophilic with H&E⁣

Electron microscopy:finely granular structures are collected on bands of collagen⁣

Pathophysiology⁣

Source of proteinaceous material forming the droplets: diffusion of serum proteins- Igs and albumins from limbal vessels to the cornea as a result of interaction with UV light⁣

Deposits are secretory products of the epithelium/stroma, which contain incomplete collagen or degraded stromal collagen⁣

Physical irritation to corneal surface from environment, sand, UV light, wind & welding burns have been associated with development & progression⁣

Symptoms⁣

Reduced vision if lesions involve central cornea⁣

Examination⁣

Yellow or golden spherules or droplets at or beneath the epithelium⁣

Located in superficial stroma, Bowman’s membrane and subepithelium,epithelium in advanced cases⁣






Management⁣

Limit sun exposure⁣

Only severe cases affecting vision need Rx - superficial keratectomy,phototherapeutic keratectomy,lamellar keratoplasty,or PK in most severe cases⁣

Complications⁣

Elevated lesions complications-epithelial defects, recurrent corneal erosions, or sterile ulceration⁣

Possible reduced corneal sensation because of deposits-sterile ulcerations can progress to microbial keratitis/perforate rapidly⁣


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