{"id":16,"url":"https://cclm.media-doc.io/conditions/16/","name":"Corneal Folds and Striae","category":"Cornea","detail":"<h2>Symptoms</h2>\n\n<ul>\n\t<li>May be asymptomatic</li>\n\t<li>Glare sensitivity in some cases</li>\n</ul>\n\n<h2>Signs</h2>\n\n<ul>\n\t<li>Folds appear as long straight dark lines in the posterior stroma, as observed in the specular reflex</li>\n\t<li>Striae appear as fine white vertical lines, which tend not to branch, in the posterior stroma</li>\n\t<li>Observed in early morning with EW lenses or high plus DW hydrogel lenses</li>\n</ul>\n\n<h2>Etiology</h2>\n\n<ul>\n\t<li>Increased hydration in posterior stroma results in separation of the ordered collagen structure</li>\n\t<li>Folds occur with edema of &gt;8%.</li>\n\t<li>Striae occur if stromal edema is &gt; 5%, with the number of striae related to the degree of corneal swelling</li>\n</ul>\n\n<h2>Prevalence</h2>\n\n<ul>\n\t<li>Occasional. Rare with modern lenses</li>\n</ul>\n\n<h2>Differential Diagnosis</h2>\n\n<ul>\n\t<li>Corneal nerves (can usually be traced to the limbus)</li>\n\t<li>Ghost blood vessels</li>\n\t<li><a href=\"/condition/23\">Keratoconus</a>&nbsp;(striae are much smaller, thinner, and more localised at the apex of the cornea)</li>\n\t<li><a href=\"/condition/61\">Corneal Dystrophies</a></li>\n\t<li>See: <a href=\"/condition/66\">Infiltrates and Opacities &ndash; Differential Diagnosis</a></li>\n\t<li>See: <a href=\"/condition/62\">Endothelial changes &ndash; Differential Diagnosis</a></li>\n</ul>\n\n<h2>Management</h2>\n\n<ul>\n\t<li>Improve lens Dk/t or Change to DW</li>\n\t<li>Manage same as for stromal edema</li>\n</ul>","images":[{"name":"Corneal Folds and Striae","file":"https://cclm-static.s3.amazonaws.com/images/folds-striae_zoom.jpg"}],"type":1,"videos":[],"wear":true,"ceaseWear":false,"changeLens":false,"changeSolutions":false,"changeCare":false,"counseling":false,"dd":false,"dw":true,"gp":false,"replace":false,"review":false,"rewettingDrops":false,"rx":false,"SiHy":true,"toric":false,"tags":[]}