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Advancing wave-like epitheliopathy in patient with floppy eyelid

Poster Details

First Author: B.Garcia-Valcarcel SPAIN

Co Author(s):    L. Ibares   C. Colliga   D. Da Saude   R. Yela           

Abstract Details


The purpose of this report was to describe an uncommon pathology, the advancing wavelike epitheliopathy (AWE), its patogénesis, posible risk factors and specific treatment


Unit of Cornea, Ophthalmology Department, Hospital Gregorio Marañon, Madrid (Spain)


A retrospective case report of patient with wave-like epitheliopathy with good response to conservative treatment


Patient of 83 years with a history of macular degeneration, dry eye and blepharitis with some episode of corneal de-epithelization in right eye His best-corrected visual acuity (VA) was 0.2 and 0.05 in right and left eyes, respectively. Slit-lamp biomicroscopy of the right eye revealed well-demarcated, centripetally advancing, and wavelike grayish irregular epithelium extending from the superior limbus toward the visual axis. Upper bulbar conjunctiva and eyelids lax. Subtarsal papillae and limbitis are absent. It is prescribed tears drops treatment and contact lens. Thyroid study results normal. The patient reports significant subjective improvement after conservative treatment, presenting a VA of 0.7


Clinical features of advancing wavelike epitheliopathy include chronic and recurrent episodes of centripetally advancing wavelike epitheliopathy that extends from the upper aspect of the limbus toward visual axis. Patients may present decreased visual acuity, ocular irritation, or redness. Differential diagnoses include superior limbic keratoconjunctivitis, and contact lens keratopathy. Predisposing factors seems to be multifactorial. Treatment with topical steroids, artificial tears, hypertonic saline solution, or therapeutic contact lenses are not effective. However our patient improve with this treatment Application of 1% silver nitrate to the upper limbus appears to be an effective treatment with a low risk of ocular adverse effects.

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