The Morphology of Corneal Epithelial Edema



Fig. 4.1
(ac) Fine granular pattern of intracellular edema (white arrowheads) and (a, c) variously large blisters (black arrowheads). The yellow-brown spots in (b) are caused by fluorescein pooling presumably within blisters (cf. Fig. 4.2)





Fluorescein Staining (1)




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Fig. 4.2
(a, b) With fluorescein, some blisters (arrowheads) stain brilliantly green while others appear dark in the green stained tear film (b, blue filter)


Fluorescein Staining (2)




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Fig. 4.3
(a) Survey of an area showing (b) dot-like structures (arrowhead) protruding in the green stained tear film; these protrusions correspond to (c) small surface excrescences (arrowhead). (d) In a different area of the same cornea, variously large blisters are visible (arrowhead) (decompensated cornea in a prephtitic eye)


Comment

The small excrescences imply swollen suprabasal cells or incipient blisters.


Fluorescein Staining (3)




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Fig. 4.4
(a, b) Two areas showing variously large blisters (black arrowheads) and (b) a fine granular pattern of intracellular edema (white arrowhead). (c) In this area, with fluorescein, small protrusions (grey arrowhead) similar to those shown in Fig. 4.3 and larger ones (black arrowhead) implying blisters are visible (the same cornea as in Fig. 4.3; cf. also Fig. 4.12d)


Bullous Epithelial Detachment




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Fig. 4.5
(ac) A large bulla (arrows) that (a, b) does not stain with fluorescein. (c) shows the detached epithelium (arrow) in a narrow light beam; the space between the epithelium and the stroma is filled with clear fluid. ((b) blue filter.) (de) A smaller bulla (arrows) captured in (d) retroillumination and (e) a narrow light beam creating optical section through its periphery. (f) Optical section through a flat bulla (bowed arrow) situated below a contact lens (dashed arrow) (see also Figs. 5.​1, 5.​5 and 5.​6)


Opaque Cysts, Epithelial Wrinkles and Subepithelial Fibrosis




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Fig. 4.6
Variously shaped, well delineated and (a) more or less strongly light-reflecting opaque cysts (arrowhead) containing (b) granular material (arrowhead) (cf. Figs. 1.​6 and 1.​7 and Chap.​ 5, Cases 2 and 3)

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Jun 8, 2017 | Posted by in OPHTHALMOLOGY | Comments Off on The Morphology of Corneal Epithelial Edema

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