A patient with a history of herpes simplex keratitis now complains of chronic photophobia and blurred vision. Slit-lamp shows focal stromal scarring with lipid deposition (lipid keratopathy) at the site of previous stromal inflammation. What is the primary mechanism of lipid deposition in this cornea?
- A Aqueous humor lipid content elevation
- B Direct infection of keratocytes by herpes simplex virus
- C Neovascularization allowing lipid leakage into the stroma ✓
- D Defective endothelial pump function
Correct answer: C. Neovascularization allowing lipid leakage into the stroma
Explanation
Lipid keratopathy occurs when corneal blood vessels (neovascularization) secondary to prior inflammation allow leakage of lipids (cholesterol, triglycerides, phospholipids) into the corneal stroma, producing a yellow-white discoloration. Without neovascularization, lipids cannot deposit in the avascular cornea. This is a common sequela of herpes simplex stromal keratitis in India.
Reference: AAO BCSC Section 8: External Disease and Cornea, 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.