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Ophthalmology General d045839b

Kayser Fleischer ring is found in which layer of cornea?

A
Bowman's Capsule
B
Substantia propria
C
Descemet's membrane
D
Endothelium
High-Yield Explanation
Kayser-Fleischer rings take the form of a crescentic rusty-brown discoloration of the deepest layer of the cornea (Descemet membrane). In the purely hepatic stage of the disease, the rings may not be evident (in 25 percent of cases), but they are viually always present (if properly sought) once the neurologic signs manifests. A slit-lamp examination may be necessary for their early detection, paicularly in brown-eyed patients, but in the majority of patients with neurologic signs the rings can be visualized with the naked eye or with the aid of an indirect ophthalmoscope focused on the limbus. Also Know: Kayser-Fleischer rings are a sign of Wilson's disease, which involves abnormal copper handling by the liver resulting in copper accumulation in the body and is characterised by abnormalities of the basal ganglia of the brain, liver cirrhosis, splenomegaly, involuntary movements, muscle rigidity, psychiatric disturbances, dystonia and dysphagia. The combination of neurological symptoms, a low blood ceruloplasmin level and KF rings is diagnostic of Wilson's disease. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 37. Inherited Metabolic Diseases of the Nervous System. In A.H. Ropper, M.A. Samuels (Eds),Adams and Victor's Principles of Neurology, 9e.

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