Lines & Rings in Ophthalmology

·         Arlt's Line = conjunctival scar in sulcus subtarsalis in Trachoma.

·         Ehrlich-Turck Line = linear deposition of KPs in uveitis

·         Ferry's Line = corneal epithelial iron line at the edge of filtering blebs.

·         Hudson-Stahil Line= Horizonatl corneal epithelial iron line at the inferior one third of cornea due to aging.

·         Khodadoust Line = corneal graft endothelial rejection line composed of inflammatory cells.

·         Paton's Line = Circumferential retinal folds due to optic nerve edema.

·         Sampaoelesi line = Increased pigmentation anterior to Schwalbe's line in pseudoexfoliation syndrome.

·         Zentmeyer line (Scheie's Line): on the equatorial surface of the lens pigment dispersion syndrome

·         Schwalbe's Line = Angle structure representing peripheral edge of Descemets membrane.

·         Stockers Line = Corneal epithelial iron line at the edge of pterygium

·         White lines of Vogt = Sheathed or sclerosed vessels seen in Lattice degeneration

·         Fingerprint lines: The map-dot fingerprint dystrophy

·         LASIK Iron Line: After LASIK for myopia, the central corneal curvature is flatter than before surgery. The tear film distribution is therefore altered, allowing some pooling centrally. This pooling can cause iron deposition in the central epithelium. A similar effect can be seen after steeping of the cornea from treatment of hyperopia. In the case of hyperopia, a pseudo-Fleischer's ring iron deposition can be seen. These iron lines do not affect vision.

·         Vogt's striae occur centrally in a patient with keratoconus. By applying digital pressure on the eye while looking through the slit lamp, these striae in the deep cornea, mostly Descemet's membrane, disappear, which is charac        teristic of keratoconus.

·         The Descemet's breaks or Haab's striae from birth trauma tend to be vertical, while the Descemet's tears associated with congenital glaucoma tend to be horizontal or curvilinear.

·         Ring Keratitis: The hallmark of Acanthamoeba keratitis

·         Kayser-Fleischer's ring: Wilson's disease

·         Corneal rust ring: A small, reddish brown, circular opacity remained in the cornea after the removal of an iron foreign body.

·         Coats' ring: remnants of a foreign body. The remnants are fine iron deposits in the cornea.

·         Fleischer's ring: visible all around the base of cone in Keratoconus

·         Pseudo-Fleischer's ring: iron deposition can be seen in Hyperopia

·         Soemmering's ring: early opacification of lens capsule in cataract

·         Vossius' ring: on lens in concussion injury to eye

·         Weiss ring: epipapillary glial tissue torn from the optic disc in Posterior vitreous detachment (PVD)

·         Double ring sign: with the peripheral margin of the encircling ring corresponding to the border of a normal-sized optic disc. Seen in Hypoplasia of the Optic Disc.

·         Schlagel lines: multiple yellow lesions at the posterior pole and periphery, arranged in clumps or linear streaks, in multifocal choroiditis

Type of Pigment
Name of Deposit
Disorder
Location in Cornea
Iron
Stocker’s line
Pterygium
Epithelium

Hudson-Stahli line
In old age
Epithelium

Ferry’s line
Filtering bleb
Epithelium

Fleischer’s ring
Keratoconus
Epithelium

Coat’s white ring
Previous Metallic foreign body injury
Bowman’s layer 


Siderosis
Stroma


Blood staining of cornea
Stroma
Copper
Kayser-Fleischer ring
Wilsons’s Disease
Descement’s membrane
Melanin
Krukenberg’s spindle
Pigment dispersion syndrome
Endothelium
Silver

Argyrosis
Stroma
Gold

Chrysiasis
Stroma

- compiled & published by Dr Dhaval Patel MD AIIMS