Introduction:

Diffuse Lamellar Keratitis (DLK), also known as Sands of the Sahara Syndrome, is an inflammatory condition that can occur following laser eye surgery, particularly laser in situ keratomileusis (LASIK). This article explores the pathophysiology, symptoms, diagnosis, and management of DLK, shedding light on this potential complication of refractive surgery.

Pathophysiology:

DLK occurs as a result of an inflammatory response within the corneal stromal interface, known as the lamellar interface, following LASIK surgery. The exact cause of DLK is not fully understood, but it is believed to be related to the presence of microorganisms or inflammatory debris trapped between the corneal layers during the surgical procedure. The inflammation can lead to the formation of white, diffuse opacities in the cornea.

Symptoms:

DLK typically presents within the first few days after LASIK surgery. The symptoms may include:

• Eye discomfort or pain: Patients may experience mild to moderate eye pain or discomfort.
• Reduced vision: Blurred or hazy vision may occur due to the opacities in the cornea.
• Light sensitivity: Increased sensitivity to light (photophobia) is a common symptom.
• Tearing: Patients may experience excessive tearing or watery eyes.
• Foreign body sensation: The feeling of having a foreign object in the eye is reported by some patients.

Diagnosis:

An ophthalmologist can diagnose DLK through a comprehensive eye examination, including:

• Slit-lamp examination: The characteristic diffuse, white opacities in the cornea can be observed using a slit lamp.
• Visual acuity testing: Vision testing helps assess the extent of visual impairment.

Management:

The management of DLK depends on its severity. Mild cases of DLK may resolve on their own without intervention, but more severe cases may require treatment. Management options include:

• Topical steroids: Steroid eye drops are often prescribed to reduce inflammation and promote resolution of DLK. The dosage and duration of steroid treatment vary based on the severity of the condition.
• Close monitoring: Regular follow-up visits with the ophthalmologist are essential to monitor the progress of DLK and adjust the treatment plan if necessary.
• Management of underlying factors: Addressing potential causes, such as infection or sterile inflammation, can aid in resolving DLK.

Conclusion:

Diffuse Lamellar Keratitis is a potential complication of LASIK surgery, leading to inflammation and opacities in the corneal stromal interface. Early recognition and appropriate management are crucial to minimize the impact on visual outcomes. Patients undergoing LASIK should be informed about the risk of DLK and advised to seek prompt medical attention if they experience any post-surgical symptoms.

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