๐๐๐ฒ๐ฌ๐๐ซโ๐ ๐ฅ๐๐ข๐ฌ๐๐ก๐๐ซ ๐จ๐ซ ๐๐ ๐ซ๐ข๐ง๐ ๐ฌ are caused by deposition of excess copper on the inner surface of the cornea in the Descemet membrane extending to the trabecular meshwork. They are usually bilateral. โฃโฃ
โฃโฃ
These rings are seen in most of the patients with neurologic involvement from WILSON DISEASE.โฃโฃ
โฃโฃ
However they are not specific to Wilson disease alone, they are also seen in other chronic cholestatic disorders such as primary biliary cholangitis, children with neonatal cholestasis, neonatal hepatitis, primary biliary cirrhosis, intraocular foreign body containing copper etc โฃโฃ
โฃโฃ
The KF ring starts at the Schwalbeโs line extending rarely more than 5 mm centrally and gradually fading towards the centre of the cornea. They occur first in the superior part of the cornea. โฃโฃ
โฃโฃ
The copper is present throughout the cornea but due to aqueous streaming, copper tends to accumulate superiorly and inferiorly, before involving the cornea circumferentially.โฃโฃ
โฃโฃ
Early KF rings can be first seen on GONIOSCOPY before they are visible on slit lamp examination.โฃโฃ
โฃโฃ
Image from Rajan Eye Care Hospital โฃโฃ
Comments