Content area
Full text
During normal epithelial turnover, the path taken by epithelial cells, as they migrate from the periphery to the centre of the cornea, is not visible. However, in several diverse clinical conditions, the cells are rendered visible by the intracellular deposition of substances like pigment, iron, drug metabolites, glycogen, and sphingolipid. 1-3 In such conditions, a vortex or whorl pattern is apparent on the corneal surface and is called vortex keratopathy or cornea verticillata. 1 3
The term "hurricane keratopathy" is used to describe the whorled or vortex distribution of cells that often occurs in the corneal epithelium during states of increased replicative turnover. 4 5 It differs from cornea verticillata in that the pattern is highlighted by fluorescein staining and does not represent the deposition of any substance. 5 It was initially considered to be restricted to grafted corneas and thought to be the toxic effect of topical steroids, or caused by the preferential migration of cells between graft sutures. 2 4
Hurricane keratopathy was later reported to occur in eyes that had not undergone a corneal graft procedure but showed evidence of chronic epithelial breakdown and healing. 5-7 Duaet al 5 6 noted that the whorled configuration of cells was "clockwise" in the majority of cases and hypothesised that this represented a response of corneal epithelial cells to ocular electromagnetic fields.
The aim of this study was to follow the clinical course of hurricane keratopathy occurring in corneal grafts and in non-grafted corneas.
Patients and methods
Thirty seven "hurricanes" in 36 eyes of 30 patients were studied. Only patients with hurricane keratopathy were recruited into the study. Six patients had bilateral hurricane keratopathy and in one patient the condition recurred in the same eye. There were 10 males and 20 females with a mean age of 61 (SD 13.3) years. The patients were examined by fluorescein staining and slit lamp biomicroscopy, and the location, direction (clockwise or anti-clockwise, Fig 1 ), relation to sutures, progression and resolution, and any residual effect on the cornea, were noted. The symptoms of the patients were also recorded. The duration of the keratopathy was measured from the time of inclusion in the study till the end of the follow up period. This underestimates the actual duration...