Corneal dystrophies can be frustrating for ODs, who could find it challenging to narrow down the diagnosis. Luckily, attendees can learn to better differentiate between epithelial/subepithelial, epithelial-stromal transforming growth factor beta-induced (TGFBI), stromal and endothelial types of dystrophies by attending Thursday, October 22’s session, “The Diagnosis and Management of Corneal Dystrophies,” presented by Susan Gromacki, OD, MS, FAAO. Dr. Gromacki will also teach each condition's association with systemic disease. The event takes place 10-11am Eastern Time.
“This course is what I call a ‘virtual hands-on’ course,” she emphasizes. “It is all about learning how to view a corneal dystrophy, and then how to diagnose it based on its physical appearance.”
Dr. Gromacki will present clinical images that she has collected from patients that she or her colleagues have seen. She notes the practical importance of teaching with these rather the ones from a textbook. “They are real-life, just how the practicing ODs would see them in their chair,” she says.
According to Dr. Gromacki, the classification of the dystrophies in her lecture will be just as the ICD has. This method, based on the layer of the cornea in which the dystrophy lies, also aids in their memorization of their appearance or characteristics. “This is important not only for clinical practice, but also for board examinations and the Academy's own Cornea, Contact Lenses and Refractive Technologies Diplomate program, which requires the passage of a visually-based, virtual examination,” Dr. Gromacki notes.
|Name that dystrophy! Attendees will be asked to make their own diagnoses from clinical images provided by Dr. Gromacki and her colleagues.|
The discussion will start with epithelial and subepithelial dystrophies such as epithelial basement membrane dystrophy and Meesman dystrophy, which usually cause minimal vision loss. Next, Dr. Gromacki will detail how to distinguish the appearances of the various epithelial-stromal dystrophies caused by the mutation of the TGFBI gene, such as Reis-Bucklers, lattice and granular types 1 and 2 (Avellino). Dr. Gromacki will provide the comprehensive management of each dystrophy in the four categories so that attendees get a better sense of monitoring for change and be more confident in their decision-making.
According to the Dr. Gromacki, her lecture will also include an in-depth review of the today's corneal transplantation procedures and how a procedure is selected based on dystrophy type and location. “Lastly, I will introduce the new in-office genetic test for over 70 mutations of the TGFBI gene, which will be commercially available next year in 2021,” she notes.
Optometry plays a significant role for patients with corneal dystrophies as the initial diagnosis and referral, when necessary, is often made by an OD. Though corneal dystrophies are rare, correctly diagnosing them in time can make a difference.