An Introduction to Cornea

In this quick introductory session, we outline a clear and practical approach to assessing corneal pathology — perfect for trainees starting out in casualty, acute clinic, or cornea services. We talk through the everyday findings you’ll encounter, how to examine each corneal layer properly, and how to integrate history and slit-lamp signs into a meaningful differential diagnosis.

Key themes include:
⭐ Why history is critical: onset of pain, contact lens use, trauma, occupation, hygiene, and risk factors.
⭐ How to examine the cornea layer-by-layer using the slit lamp: epithelium → stroma → Descemet’s → endothelium → anterior chamber.
⭐ Epithelial findings: erosions, filaments, punctate keratitis and oedema.
⭐ Iron lines: Ferry, Stocker, Hudson–Stähli, and Fleischer rings — where they appear and why they matter.
⭐ Stromal pathology: infiltrates, oedema, and pannus.
⭐ Endothelial findings: Descemet’s folds and breaks, guttata, pigment deposition, and keratic precipitates.

Take-home messages:
🌟 Corneal findings are often non-specific — history is what narrows down the diagnosis.
🌟 Examine systematically and slowly; use different illumination angles to see each layer properly.
🌟 Pain out of proportion, ring infiltrates, atypical staining → think beyond simple causes.
🌟 Always link your findings with the patient’s systemic and ocular background.
🌟 Management changes dramatically depending on whether the cause is infective or inflammatory — don’t guess.

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