Band Keratopathy

What’s going on?
Chronic eye disease (such as persistent intraocular inflammation) affects the metabolic milieu of the cornea. There is deposition of calcium into the superficial corneal stroma, occurring in the interpalpebral band, running horizontally between the upper and lower lids across the centre of the cornea. Gradually, vision is reduced by the white corneal opacity.

If I examine the patient, what will I find?
There will be a band of white across the middle of the cornea extending horizontally but with a clear 1mm strip at the limbus, both nasally and temporally.

What if I’ve diagnosed it?
There must be an underlying pathology so the patient needs investigating. Referral should be soon via letter. The exception is children, who should be referred urgently.

What will the hospital do?
An underlying aetiology will be determined and appropriate management initiated. If the band keratopathy affects vision, the calcium may be leached out with topically applied chelating agents in theatre.

What do I need to do?
Rarely, this condition occurs secondary to systemic hypercalcaemia, so it may be worth checking serum calcium level.

What to tell the patient
The calcium deposition can be removed but will recur if the underlying pathology is not addressed.