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SYMPTOMS
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Foreign body sensation | Often asymptomatic
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SIGNS
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An area of corneal thinning/excavation adjacent to corneal elevation - usually around the limbus | Injection
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WORK-UP
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Thorough history. Slit lamp examination with NaFl dye
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TREATMENT
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Preservative-free artificial tears q2-4h | Lubricating ointment at night | Surgical removal/repair of the lesion may be indicated
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FOLLOW-UP
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Every couple of days during treatment
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ETIOLOGY
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Many conditions of limbal elevation may cause corneal dellen, including: Filtering blebs | Pterygium | Pinguecula | Trauma
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DIFFERENTIAL DX
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Peripheral ulcerative keratitis | Infectious keratitis | Limbal stem cell deficiency
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NOTES
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Dellen are a result of tear film disturbance | Rarely, corneal perforation and scarring may result
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