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. 2000 Mar;84(3):285–288. doi: 10.1136/bjo.84.3.285

Clinical course of hurricane keratopathy

H Dua 1, J Gomes 1
PMCID: PMC1723403  PMID: 10684839

Abstract

BACKGROUND/AIMS—"Hurricane keratopathy" is the name given to the whorl pattern, highlighted with fluorescein, seen in situations where corneal epithelial cell turnover is exaggerated. Although the condition is well described, follow up data on patients with this condition and its sequelae have only been reported in corneal graft patients. The aim was to study the clinical course of hurricane keratopathy in corneal graft patients and contact lens wearers, and to document any sequelae of this condition.
METHODS—Hurricane keratopathy, occurring in 20 eyes with corneal grafts and 16 eyes (six bilateral) wearing rigid gas permeable contact lenses, was studied and followed. The occurrence, pattern, progress, resolution, and residual effects of the whorls were noted.
RESULTS—Hurricane keratopathy was noted to occur in grafts as previously reported and also in contact lens wearers, which has hitherto not been reported. The whorls usually appeared within the first 3 weeks postoperatively and persisted up to 4 months. A small epithelial defect (11.1%), heaped epithelial cells (5.6%), and a nebular grade opacity (2.8%), were the only significant sequelae noted at the epicentre of the whorls. Resolution occurred from the periphery towards the centre of the cornea.
CONCLUSIONS—The whorl pattern is sustained as long as the stimulus for increased cell turnover is maintained. Once this stimulus is eliminated, the pattern tends to resolve spontaneously.



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Figure 1  .

Figure 1  

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(A) Diagram representing a clockwise whorl. When a whorl on either eye conformed to the appearance in (A), it was deemed to be a clockwise whorl. (B) Diagram representing an anti-clockwise whorl. When a whorl on either eye conformed to the appearance in (B), it was deemed to be an anti-clockwise whorl.

Figure 2  .

Figure 2  

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A temporally located clockwise whorl in the right eye of a patient with a corneal graft. There is no epithelial defect in the centre of the whorl.

Figure 3  .

Figure 3  

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(A) A centrally located anti-clockwise whorl in the right eye of a patient with bilateral keratoconus wearing rigid gas permeable contact lenses. There is an epithelial defect at the epicentre of the whorl. (B) A centrally located clockwise whorl in the left eye of the same patient. There is a tiny epithelial defect at the epicentre of the whorl.

Figure 4  .

Figure 4  

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A centrally located clockwise whorl in the left eye of a patient with a corneal graft. There is an area of heaped epithelium at the centre, which is not staining with fluorescein.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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