Hello and welcome to Case of the Day. I’m Dr Croley and today we’re gonna discuss an interesting patient who came in with a complaint that her vision was blurred and wasn’t really sure how long it had been going on for but slowly within the last year or so, her vision had gradually decreased. And so a lot of them see the need to come to the office that way, the first thing that you’ll think was that they may have Cataracts. But in this particular case, this lady did not have Cataracts, she had what’s called Band Keratopathy. And so what she had actually is a deposition of Calcium or endorphosphorus deposits on the surface of the cornea, the clear part of the eye. So these deposits happen usually in the anterior layers of the the eye down to a layer called Bowman’s membrane. Sometimes it penetrates below Bowman’s membrane, depending on how long it’s been present for. And actually it’s a band. It actually looks like a band across the cornea that is whitish in appearance and if it’s dense enough and located in the pupil area, then it can obstruct the vision and in her case that’s what was happening.
So what causes Band Keratopathy? It can be from several different causes. If you were a young person and had this developed, then you have to worry about is your blood levels of your Calcium very highly elevated. Such diseases as Hyperparathyroidism. It happens in certain Multiple Myeloma malignancies. It happens in certain people in renal failure. It happens in certain eye diseases such as if someone has a sick eye, they have a lot of trouble with their eye they have what’s it’s called
Phthisis bulbi in which the pressure in the eye is very low or zero and in this sick eye, people develop Calcium deposits. And in those situations, chronic trauma to the eye, a drug called Pilocarpine that was used many years ago for Glaucoma, the mercury in there could cause that to develop Band Keratopathy. So there are several things that can cause it but there is treatment for it.
So this lady, we’re gonna be scheduling her to go in and remove these Calcium deposits. And the most common treatment is we go to the operating room and then we place on the eye either an alcohol solution that loosens the Epithelium off or you can actually scrape the Epithelium off the cornea and then you apply a EDTA, which is a Calcium-chelating agent so it binds to the Calcium and draws it out of the cornea. And sometimes we have to scrape or rub along as it comes loose and that works pretty well on most cases.
After that case is over, we typically apply a soft contact lens to cover over the Epithelium that’s been removed so the eye is not that painful afterwards. If it doesn’t respond well to that, then also laser correction, that we use to actually correct someone’s vision because they’re nearsighted or farsighted. With the laser, that laser cuts to remove corneal tissue so you can have a therapeutic PRK or laser treatment in severe cases that don’t respond to EDTA. It doesn’t happen very often but when we do see it, then the good thing is that it is treatable.
So if you have any questions about this type of thing with the Band Keratopathy or any of the eye question, you’ll be happy to try contact us through the website and we’ll try to answer those questions for you. If not, may God grant you with healthy eyes and great vision.