OPHTHALMOLOGICAL SIGNS

Ranjani ramachandran

Bitot's spot=White,foamy area of keratinising squamous metaplasia of bulbar conjunctiva,seen in vitamin A deficiency.

Brushfield spot=Whitish grey spot in peripheral iris,seen in Down's syndrome.

Elschnig spot=Yellow patches overlying area of choroidal infarction in hypertension. Fischer-Khunt spot=Senile scleral paque,area of hyalinised sclera anterior horizontal rectus muscle insertion.Seen in old age. Fuch's spot=Pigmented (RPE hyperplasia) macular leisons in pathological myopia.

Gunn's dot=light reflectios from internal limiting membrane around disc and macula
Horner-Trantras Dot=Collections of eosinophils at limbus in vernal conjunctivitis. Kayes' dot=subepithelial infiltrates seen in corneal graft rejection Mittendorf's dot=whitish spot at posterior lens surface,remnant of hyaloid artery. Roth spots=haemorrhageswith white centres,seen in SABE, severe anaemia,collagen vascular disorders.

BITOTS SPOT

Vitamin A deficiency
Mostly Bilateral

Often present temporally

Keratinization n accumulation of debris n bacteria Can be a sign of conjunctival xerosis without Vit A deficiency Can be black sometimes, main ly in india due to the deposition of antimony powder from kohl or kajal

Brushfield spots

Aggregates of stromal cells( group of connective tissues) Associated with downs syndrome these are patches of hyperplasia along with group of hypoplastic cells Often compared with wolffian bodies which are similar present more at the periphery, normally found in 15% of the babies These are more found in caucassians due to their lighter colord iris compared to asian race

at the periphery of the iris.

Elschnig spots
Black flecks or spots surrounded by yellow or red halos Sign of hypertensive retinopathy(chronic) areas of ischemic infarcts of choroid with hyperpigmentation Clumps and atropy of the retina. in acute cases can be present with areas of retinal detachment

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FISCHER KHUNNT SPOT

FOSTER-FUCHS SPOTS
Often seen in pathological myopia( alteration in the globe) Macular degenartion with subretinal neovascularization Often seen as distorted straight lines near the fovea at the initial stages later presents as well circumscribed patches after the absorption of hemorrhage and when scar remains Central sight is affected

Atrophy leads to 2-3 lines loss in snellen chart

GUNNS SPOT

KAYES SPOTS
Often seen with corneal graft rejection These are subepithelial infiltrates ( of two types) The first type is characterized by an irregular, elevated epithelial rejection line that stains with fluorescein or rose bengal. The rejection line progresses rapidly across the cornea over several days to 2 weeks. A variant of this presentation may occur in which the epithelial rejection line takes the form of a ring, concentric with the limbus, which begins peripherally at the graft-host junction and progresses by shrinking centrally to a point. The rejection line represents a region of destruction of donor epithelium; the resulting epithelial defect is covered by host epithelium that grows inward from the remaining host cornea and limbus to cover the graft. The second type of epithelial rejection is characterized by the presence of subepithelial infiltrates. These infiltrates consist of leukocytes and frequently have an appearance similar to the subepithelial infiltrates seen in adenoviral keratoconjunctivitis. These lesions may change location and shape over time, and they generally disappear on their own after several weeks. Both the types are responsive to steroid treatment Asymptomatic or minimally irritative Less presented