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CORNEAL DRAWINGS
History
• Schepens (1969): Retinal drawing
• “A simple scheme for documenting corneal
disease”
Bron AJ. Br J Ophthalmol 1973, 57:629

• Systematic method of drawing corneal pathology
Waring GO 3rd, Laibson PR. Arch Ophthalmol 1977,95:1540
Why draw?
•
•
•
•

Standardization of documentation
Easy follow-up
Teaching
Cheaper
• color pencils: erasable
Red,Blue,Green,Yellow,Black,Brown
∀ ↑ Observation power & S/L skills
• Drawing v/s photo: cost, area of interest
How to draw? Color codes
BLACK
•
•
•
•
•
•
•
•

Scar
Degeneration / deposits / guttatae
Sutures
CL (broken line) i.e contact lens
FB i.e foreign body
Tissue adhesive
Corneal nerves / Vogt’s striae
IOL– show only in corneal slit
How to draw? Color codes
BLUE
• Epithelial edema
• Epithelial bullae
• Stromal edema
• DM(descemet membrane) folds
How to draw? Color codes
YELLOW
• Infiltrate
• Hypopyon
• KPs
• Lens (cataract)
How to draw? Color codes
GREEN
• Epithelial defect
• Fluorescein stain
• SPKs
• Filaments
• Vitreous
How to draw? Color codes
RED
• Blood vessels
Superficial
Deep
Ghost
• Hyphema
• Filaments
• Rose bengal
How to draw? Color codes
BROWN
• Pigments
(Iron lines, epi. melanosis, Kruckenberg’sspindle )
• Iris
• Pupil
• PAS i.e peripheral anterior synaechia
How to draw?
Frontal view
Slit view
Vital stains
How to draw?
•
•
•
•

Circle (35 mm?)
Pupil
Outline opacities: “Sclerotic scatter”
Scar v/s infiltrate v/s edema:
Scar: Grey-white, ↑ reflectance, ↓ thickness,
“Zebra pattern”
Infiltrate: Yellowish, diffuse slit, cellular
Edema: Ground glass, ↑ thickness of slit
How to draw?
•
•
•
•
•
•

Add vessels, pigments, folds etc.
Fine details: Go quadrant wise
Sutures
BCL, tissue adhesive
Draw separately lens & AV (If needed)
No details other then on the cornea:
NO hypopyon/hyphema, AC exudates, FB in AC
How to draw?
•
•
•
•
•
•
•

Depict the site of slit on the frontal view
Dotted posterior line: post surface not visible
Stromal thickness: bow behind
Area of thinning: mention %
Descemetocele
AC depth and lesions in AC
Lens, vitreous, IOL
How to draw?
• Last to be done
• SPKs: “Remember, numbers are imp.”
• “Separate diagram if needed”
How to draw?
• Slit lamp:
• Slit height
• Graticule
• Coaxial illumination, narrow slit
• “Mention shape of lesion”
• Mention landmark of measurement
• Ulcer: max. diameter, mark it with arrows
Important pearl
FOLLOW THE CLOCK HOUR RULE FOR
PERFECT DRAWING
Happy Drawing!!

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Corneal drawings

  • 2. History • Schepens (1969): Retinal drawing • “A simple scheme for documenting corneal disease” Bron AJ. Br J Ophthalmol 1973, 57:629 • Systematic method of drawing corneal pathology Waring GO 3rd, Laibson PR. Arch Ophthalmol 1977,95:1540
  • 3. Why draw? • • • • Standardization of documentation Easy follow-up Teaching Cheaper • color pencils: erasable Red,Blue,Green,Yellow,Black,Brown ∀ ↑ Observation power & S/L skills • Drawing v/s photo: cost, area of interest
  • 4. How to draw? Color codes BLACK • • • • • • • • Scar Degeneration / deposits / guttatae Sutures CL (broken line) i.e contact lens FB i.e foreign body Tissue adhesive Corneal nerves / Vogt’s striae IOL– show only in corneal slit
  • 5. How to draw? Color codes BLUE • Epithelial edema • Epithelial bullae • Stromal edema • DM(descemet membrane) folds
  • 6. How to draw? Color codes YELLOW • Infiltrate • Hypopyon • KPs • Lens (cataract)
  • 7. How to draw? Color codes GREEN • Epithelial defect • Fluorescein stain • SPKs • Filaments • Vitreous
  • 8. How to draw? Color codes RED • Blood vessels Superficial Deep Ghost • Hyphema • Filaments • Rose bengal
  • 9. How to draw? Color codes BROWN • Pigments (Iron lines, epi. melanosis, Kruckenberg’sspindle ) • Iris • Pupil • PAS i.e peripheral anterior synaechia
  • 10. How to draw? Frontal view Slit view Vital stains
  • 11. How to draw? • • • • Circle (35 mm?) Pupil Outline opacities: “Sclerotic scatter” Scar v/s infiltrate v/s edema: Scar: Grey-white, ↑ reflectance, ↓ thickness, “Zebra pattern” Infiltrate: Yellowish, diffuse slit, cellular Edema: Ground glass, ↑ thickness of slit
  • 12. How to draw? • • • • • • Add vessels, pigments, folds etc. Fine details: Go quadrant wise Sutures BCL, tissue adhesive Draw separately lens & AV (If needed) No details other then on the cornea: NO hypopyon/hyphema, AC exudates, FB in AC
  • 13. How to draw? • • • • • • • Depict the site of slit on the frontal view Dotted posterior line: post surface not visible Stromal thickness: bow behind Area of thinning: mention % Descemetocele AC depth and lesions in AC Lens, vitreous, IOL
  • 14. How to draw? • Last to be done • SPKs: “Remember, numbers are imp.” • “Separate diagram if needed”
  • 15. How to draw? • Slit lamp: • Slit height • Graticule • Coaxial illumination, narrow slit • “Mention shape of lesion” • Mention landmark of measurement • Ulcer: max. diameter, mark it with arrows
  • 16. Important pearl FOLLOW THE CLOCK HOUR RULE FOR PERFECT DRAWING
  • 17.