CORNEAL OPACITY

HSV infection
• Corneal scar and iris atrophy from
HSV stromal keratitis

• Corneal dendrite highlighted by

rose bengal from herpes simplex
virus
 HZV infection
• Dendrite from primary herpes
zoster virus (HZV) infection

• Neurotrophic ulcer following

herpes zoster ophthalmicus

• Corneal melt after HZV

necrotizing stromal keratitis
EBV infection
Bacterial Corneal Ulcer
• Acanthamoeba keratitis with severe
punctate keratopathy and early central
corneal haz

• Central corneal ulcer and radial

perineuritis from Acanthamoeba

• Ring ulcer and stromal necrosis from late

Acanthamoeba keratitis.
Fungal Keratitis
Corneal Inflammation
and Surface Disorders
• Interstitial keratitis from
congenital syphilis with
ghost vessels on
retroillumination

• Herpes simplex virus

interstitial keratitis and
corneal scarring.
• Punctate keratitis and
multiple corneal opacities
typical of Thygeson
superficial punctate keratitis.
Shield Ulcer
• Peripheral vernal shield ulcers
seen in vernal
keratoconjunctivitis
Filamentary Keratitis
• chronic epithelial defects or ulceration
are seen at presentation
• punctate corneal staining in the central
or inferior cornea w/o associated
epithelial defects
• Corneal thinning, filamentary keratitis,
scarring, corneal surface asperity, and
an elevated hyperplastic epitheliopathy
can be associated findings
Stromal Corneal Dystrophies
• common bilateral autosomal
dominant stromal dystrophy
• bread crumb–like opacities,
typically in the central portion of
the anterior stroma  hyaline
(Masson trichrome stain)
• globular shape of both corneas
with large corneal diameters.
Associated generalized thinning
occurs, more concentrated in the
midperiphery
• The anterior chamber is very deep
Arcus senillis
Limbal Girdle of Vog
• degeneration of collagen
develops in the peripheral cornea
and may contain particles of
calcium.
• Chalklike opacification
• begins at 3 and 9 o’clock
Mooren Ulcer
• aggressive peripheral ulcerative keratitis with a high risk of corneal
melting and perforation