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http://www.revoptom.com/content/c/20600/
VOLUME 2, NUMBER 13
AUGUST 1, 2011

IF YOU DETECT A SWIRLING OR WHORL-LIKE PATTERN ON THE CORNEA (CORNEAL VERTICILLATA), YOU SHOULD IMMEDIATELY CONSIDER SEVERAL DIFFERENTIAL DIAGNOSES—ONE OF WHICH IS POTENTIALLY LIFE THREATENING.

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Because most patients are unaware of any symptoms related to corneal verticillata, the clinician must make this diagnosis on external examination. So, what are the potential causes of bilateral corneal verticillata or vortex keratopathy?

One common cause includes corneal saturation with certain medications, such as amiodarone, chloroquine and indomethacin. If, however, a patient has no relevant ocular history, is not using one of these medications and has not experienced previous trauma or stem cell injury, the diagnosis might be Fabry disease.

In this image, the patient never used any of the aforementioned medications. He was referred to an internist for analysis of potential alpha-galactosidase enzyme deficiency, which can result in glycolipidosis.

Patients with Fabry disease often complain of severe joint pain and skin lesions known as angiokeratomas. If undiagnosed, the disease can lead to cardiovascular or renal failure. Treatment is available if Fabry disease is diagnosed promptly. Otherwise, the condition is 100% fatal.

Finally, because Fabry disease has a genetic component, our patient's family members also have been scheduled for ocular examinations.

http://www.revoptom.com/content/c/20600/

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