Summary about Disease
Band keratopathy is a corneal degeneration characterized by a band-shaped opacity in the interpalpebral zone (the area between the eyelids) of the cornea. This opacity typically begins at the periphery and progresses centrally. It involves calcium deposition within Bowman's layer, the acellular layer beneath the corneal epithelium.
Symptoms
Gritty or sandy sensation in the eye
Eye pain
Blurred vision
Foreign body sensation
Redness
Increased tearing
Visible band-shaped opacity on the cornea
Causes
Chronic ocular inflammation (e.g., uveitis, dry eye disease)
Hypercalcemia (high blood calcium levels, though less common as a direct cause)
Chronic kidney disease (renal failure)
Exposure to mercury vapor
Hereditary factors (rare)
Phthisis bulbi (shrunken, nonfunctional eye)
Silicone oil in the anterior chamber (after retinal surgery)
Medicine Used
Chelating Agents: Topical EDTA (ethylenediaminetetraacetic acid) is the primary medical treatment. EDTA is a chelating agent that binds to calcium, helping to dissolve the calcium deposits in the cornea.
Lubricating Eye Drops: Artificial tears can alleviate dryness and discomfort.
Steroid Eye Drops: In some cases, steroid eye drops may be used to reduce inflammation, but with caution due to potential side effects.
Is Communicable
No, band keratopathy is not communicable. It is a degenerative condition caused by local or systemic factors, not an infectious agent.
Precautions
Manage underlying conditions (e.g., uveitis, hypercalcemia).
Use lubricating eye drops to prevent dryness.
Protect eyes from injury and excessive sun exposure (sunglasses).
Regular eye exams are crucial, especially with predisposing conditions.
How long does an outbreak last?
Band keratopathy is not an "outbreak" in the infectious disease sense. It's a chronic, progressive condition. Without treatment, it persists indefinitely and worsens over time. The progression rate varies depending on the underlying cause and individual factors.
How is it diagnosed?
Slit-lamp examination: A thorough examination of the cornea using a slit lamp microscope. The characteristic band-shaped opacity is readily visible.
Review of medical history: To identify potential underlying causes like uveitis, hypercalcemia, or kidney disease.
Calcium level testing: If hypercalcemia is suspected.
Kidney function tests: If chronic kidney disease is suspected.
Corneal topography/pachymetry: To assess corneal irregularities and thickness.
Timeline of Symptoms
The timeline of symptoms is generally slow and progressive:
Early Stages: Often asymptomatic or mild gritty sensation.
Progression: Development of a visible, faint band-shaped opacity at the periphery of the cornea. Gradual increase in size and density of the opacity. Increased discomfort, blurred vision.
Advanced Stages: Denser, more prominent opacity covering a larger portion of the cornea. Significant vision impairment. Pain and foreign body sensation may be more pronounced.
Important Considerations
Underlying Causes: Identifying and managing the underlying cause is critical to slowing or preventing further progression.
Treatment Goals: Treatment aims to alleviate symptoms, improve vision, and prevent further calcium deposition.
Surgical Intervention: In severe cases, superficial keratectomy or phototherapeutic keratectomy (PTK) may be considered if EDTA chelation is insufficient.
Monitoring: Regular follow-up appointments are essential to monitor the condition and adjust treatment as needed.
Visual Rehabilitation: Corrective lenses (glasses or contact lenses) may be needed to optimize vision after treatment.