Introduction:

Corneal dellen are localized areas of corneal thinning or depression that can develop due to various factors affecting the ocular surface. These shallow, saucer-shaped lesions can cause discomfort and visual disturbances. Understanding the causes, symptoms, and appropriate management of corneal dellen is crucial to prevent potential complications and preserve ocular health.

Causes of Corneal Dellen:

Corneal dellen can arise from a variety of conditions and factors that affect the corneal surface and tear film. Some common causes include:

• Elevated or Uneven Eyelid: Abnormalities in eyelid position or movement, such as ectropion or lagophthalmos, can create uneven distribution of tear fluid over the cornea, leading to localized corneal thinning.
• Contact Lens Wear: Improperly fitted or over-worn contact lenses can induce focal corneal thinning due to compromised oxygen and tear exchange.
• Dry Eye Syndrome: Insufficient tear production or poor tear film quality can cause dry spots on the corneal surface, contributing to dellen formation.
• Pterygium: A pterygium, an abnormal growth of conjunctival tissue onto the cornea, can cause adjacent corneal thinning.
• Conjunctival Tumors or Masses: Large conjunctival lesions adjacent to the cornea can lead to pressure-related corneal thinning.

Symptoms of Corneal Dellen:

The presence of corneal dellen may cause a range of symptoms, including:

• Eye Discomfort: Patients may experience mild to moderate discomfort or foreign body sensation.
• Blurry Vision: Corneal dellen can cause irregular astigmatism, leading to visual distortion and blurry vision.
• Redness: Localized redness of the affected area may be present due to irritation and inflammation.
• Tearing: The eye may produce excess tears as a response to the corneal thinning.

Management of Corneal Dellen:

The treatment and management of corneal dellen depend on the underlying cause and severity of the condition. Some common approaches include:

• Artificial Tears: The use of preservative-free artificial tears can help improve tear film stability and alleviate dry eye-related dellen.
• Lubricating Ointments: Ophthalmic ointments may be prescribed to provide longer-lasting lubrication, particularly during sleep.
• Adjustment of Contact Lenses: Proper fitting of contact lenses or temporary discontinuation of contact lens wear may be necessary to relieve corneal stress.
• Eyelid Management: Addressing eyelid abnormalities through lid hygiene or surgical correction can improve tear distribution and prevent recurrent dellen.
• Management of Pterygium: Surgical removal of a pterygium may be indicated if it is contributing to corneal thinning.

Preventing Complications:

If left untreated, corneal dellen can lead to corneal ulceration and potential vision-threatening complications. Seeking timely evaluation and appropriate management is essential to prevent further corneal damage and preserve visual function.

Conclusion:

Corneal dellen are localized areas of corneal thinning that can result from various ocular surface conditions. Recognizing the causes, symptoms, and management options is essential for preserving ocular health and preventing potential complications.

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