Dellen

Dellen
SYMPTOMS Foreign body sensation | Often asymptomatic
SIGNS An area of corneal thinning/excavation adjacent to corneal elevation - usually around the limbus | Injection
WORK-UP Thorough history. Slit lamp examination with NaFl dye
TREATMENT Preservative-free artificial tears q2-4h | Lubricating ointment at night | Surgical removal/repair of the lesion may be indicated
FOLLOW-UP Every couple of days during treatment
ADDITIONAL LAB | TESTS None
ETIOLOGY Many conditions of limbal elevation may cause corneal dellen, including: Filtering blebs | Pterygium | Pinguecula | Trauma
DIFFERENTIAL DX Peripheral ulcerative keratitis | Infectious keratitis | Limbal stem cell deficiency
NOTES Dellen are a result of tear film disturbance | Rarely, corneal perforation and scarring may result