eye disorders
Bullous Keratopathy
Diagnosis of Bullous Keratopathy
Slit-lamp examination Ultrasonic pachymetry Slit-lamp examination of all types of bullous keratopathy reveals corneal epithelial bullae and swelling of the corneal stroma. Fuchs dystrophy also demonstrates multiple minute excrescences (guttata) on the endothelial surface and/or thickening of Descemet's membrane, giving a “beaten metal” appearance to the back surface of the cornea. All the symptoms and findings are characteristically worse when patients first wake up and improve throughout the day. This is because moisture accumulates—and edema worsens—when the eyes are closed during sleep and progressively dries by evaporation when the eyes are open. Also required for diagnosis of all types of bullous keratopathy is increased corneal thickness as measured by ultrasonic pachymetry. 