Tuesday, 29 November 2016

Cornea General Features

CORNEA GENERAL FEATURES
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Anatomy of Cornea
Anterior surface
elliptical
Posterior surface
circular
Corneal horizontal diameter of both surfaces in  adult
11.7mm
Corneal vertical diameter of anterior surfaces in  adult
11.7mm
Corneal vertical diameter of posterior surfaces in  adult
10.6mm
Cornea diameter at birth
10mm
Cornea attains adult diameter
2 years
Thickness of cornea at centre
0.5 – 0.6 mm
Radius of curvature on anterior surface & posterior surface of cornea
7.8 mm & 6.5 mm
The vertical meridian of cornea is 0.05 steeper   than the horizontal meridian
Astigmatism with the rule
Refractive power
43-44 D(3/4th of total dioptric power of eye)
Refractive index
1.376
Most of refraction in eye occur at
Anterior surface of cornea(air-tear interface)
Megalocornea
The horizontal diameter is of adult size at birth or >/ 13 mm after the age of 2 years
Megalocornea
Marfan syndrome
Ehler danlos syndrome
Down syndrome
Apert syndrome
Microcornea means diameter less than
10 mm
Microcornea
Autosomal dominant associated with hypermetropia, associated with fetal alcohol syndrome
Long collagen fibres with wide spacing between them
Cornea
Critical angle for cornea air interface
46*
Epithelium of cornea
Stratified squamous non keratinizing
Corneal epithelium
Hydrophobic
Bowman’s membrane
Once destroyed,doesn’t regenerated
Not a true membrane,condensed superficial stroma
Stroma (substantia propria)
Occupies 90% of thickness
Consists of collagen fibres in hydrated matrix of proteoglycans
Dua’s layer is between
Corneal stroma and descemet membrane
Termination of descemet membrane
Ring of schwalbe
Endothelium
Single layer of flat polygonal cells
Cell density - around 3000 cells/mm2 in young adults
Metabolically active layer
Has active pump mechanism
Most important layer in maintaining transparency
Regeneration occurs rapidly after injury(decompensation occurs only after >75% cells are lost
Krukenberg spindle is seen
Regeneration of corneal epithelial cells from
Palisade of Vogt
Corneal transparency is due to
Homogeneity of refractive index throughout the epithelium
avascularity, Peculiar arrangement of lamellae,Uniform spacing of collagen fibrils in stroma
Unmyelinated nerve fibres
Relatively dehydrated state
Na+ K+ pump,Bicarbonate dependent ATPase,Na+/H+ pump
Normal IOT
Ion pump in corneal endothelium is necessary for maintaining transparency. it can be blocked by
Inhibition of anaerobic glycolysis
Avascular coat in eye
Cornea
The most actively metabolizing layers of cornea
Epithelium & Endothelium
Cornea receives nutrition form
Atmosphere, aqueous humour,perilimbal capillaries
Corneal vascularization is associated with
Riboflavin deficiency
Corneal neovascularization is caused by
Graft rejection, Chemical burn, Contact lens usage, Viral

or fungal keratitis
Corneal neovascularization can be prevented by
Photocoagulation

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