2020–2021 BCSC Basic and Clinical Science Course™
4 Ophthalmic Pathology and Intraocular Tumors
Part I: Ophthalmic Pathology
Chapter 6: Cornea
Degenerations, Depositions, and Ectasias
Calcific Band Keratopathy
Seen clinically as a band-shaped calcific plaque in the interpalpebral zone typically sparing the most peripheral clear cornea, calcific band keratopathy is characterized by the deposition of calcium at the level of Bowman layer and the anterior stroma. The calcium deposits appear as intensely basophilic (dark purple) granules in H&E sections; the presence of calcium can be further confirmed with the use of special stains such as alizarin red or von Kossa (Fig 6-10).
Figure 6-10 Calcific band keratopathy. A, Clinical photograph showing a white bandlike opacity extending from 3 o’clock to 9 o’clock, sparing the perilimbal cornea. B, The calcium is deposited at the level of Bowman layer (arrows), appearing deeply basophilic (dark purple) on H&E stain. C, Calcium deposits appear black with von Kossa stain.
(Part A courtesy of Anthony J. Lubniewski, MD; part B courtesy of George J. Harocopos, MD; part C courtesy of Hans E. Grossniklaus, MD.)
Band keratopathy may develop in chronically inflamed and/or traumatized eyes, following intraocular therapy (eg, intravitreal silicone oil), and, less commonly, in association with systemic hypercalcemic states. The exact pathophysiology is not well understood.
Excerpted from BCSC 2020-2021 series: Section 4 - Ophthalmic Pathology and Intraocular Tumors. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.