Central corneal pathologies

Background Central corneal pathologies can lead to an irreversible decrease of best corrected visual acuity if not diagnosed and treated appropriately . This article reviews the differential diagnosis of central corneal opacit ies in the newborn, of central infectious corneal ulcers, and the therapy o f sterile, central keratolysis. Material and methods Authors' personal experience and review of the literat ure. Results Flow charts for diagnosis and treatment strategy have been elaborat ed. Conclusions Corneal opacities in newborns create an emergency situation. In order to treat successfully and avoid or diminish amblyopia, it is imperat ive to rule out congenital glaucoma. The aetiology of central corneal ulcer s should always be confirmed by positive cultures to be able to treat speci fically. When the standard topic therapy fails, one has to consider rare ba cteria, parasites, virus, or patients' compliance. The treatment of central sterile keratolysis in rheumatoid arthritis must be intensive and immunosu ppression has to be performed early enough in the course to prevent the for mation of a descemetocoele or spontaneous corneal perforation.