Various Lines in Ophthalmology

Arlt's Line :

• Horizontal line of conjunctival scarring in sulcus subtarsalis of superior palpebral conjunctiva.
• Seen in Trachoma.

Ehrlich-Turk Line :

Vertical linear deposition of KPs in uveitis.

Ferry's Line :

Corneal epithelial iron line at the edge of filtering blebs of glaucoma surgery.

Hudson-Stahli Line :

Iron deposition line in the corneal epithelium, which commonly seen in the junction between middle and lower third cornea.

Khodadoust Line :

• Corneal graft endothelial rejection line composed of inflammatory cells.
• Khodadoust's line separates immunologically damaged endothelium - usually originating from neovascularization in the same area - from the unaffected endothelium. In the area of damage the endothelium is decompensated resulting in stromal and epithelial edema. Timely immuno-suppression can reverse this process.

Endothelial rejections :Most severe form of corneal rejection as this layer doesn’t have regenerative property & significant cell loss can cause chronic graft edema.

• Classic endothelial rejection presents with an endothelial rejection line (Khodadoust line) that usually begins at a vascularized portion of the peripheral graft-host junction and progresses, if untreated, across the endothelial surface over several days. The rejection line consists of mononuclear white cells that damage endothelial cells as the line sweeps across the endothelium.
• Generally, a mild-to-moderate anterior chamber reaction is present. The damaged endothelium is unable to properly dehydrate the corneal graft; as a result, the donor cornea is clear ahead of the rejection line and is cloudy and edematous behind it.
• A second variant of endothelial rejection is more diffuse in character, with scattered keratic precipitates and an anterior chamber reaction indicative of endothelial rejection and damage. In this type of endothelial rejection, stromal edema typically is not localized, but rather generalized throughout the graft, consistent with the generalized endothelial damage. The combination of keratic precipitates, an anterior chamber reaction, circumcorneal injection, and regions of corneal edema should be diagnosed as corneal graft rejection. In some cases, it may be difficult to distinguish graft edema from rejection and graft edema from endothelial insufficiency. Since rejection may be reversible, it is best in these situations to treat patients as if they have graft rejection.

Paton's Line :

• Circumferential retinal folds in peripapillary region due to papilledema.
• Papilledema is defined as optic nerve head edema secondary to increased intracranial pressure. The main cause of optic nerve head swelling is blockage of the axoplasma transport and the blockage occurs at the lamina cribrosa.
• The optic nerve head can swell to the extent where it is extended forward into the vitreous as well as laterally. This lateral swelling causes the retina to buckle inward at the temporal aspect of the optic nerve head. The buckling is know as Paton's lines or folds.

Sampaolesi line :

• Wavy line of Increased pigmentation anterior to Schwalbe's line.
• Occurs in

1. pseudoexfoliation syndrome
2. pigment dispersion syndrome
3. trauma
4. iris melanoma

Scheie's Line or Zentmayer's line :

• Pigment on lens equator and posterior capsule in pigment dispersion syndrome.
• Peripheral pigmentation of the posterior lens capsule anterior to the junction between the anterior hyaloid face and the posterior lens capsule (ligamentum hyaloideo-capsulare of Wieger)
• "Scheie's line" is considered to be pathognomonic for pigment dispersion syndrome.

Schwalbe's Line :

• Termination of Descemet's membrane .
• Line where corneal scleral meshwork terminates anteriorly .Delineates the outer limit of the corneal endothelium layer.

Stockers Line :

Corneal epithelial iron line at the edge of pterygium.

White lines of Vogt :

• Sheathed or sclerosed vessels seen in Lattice degeneration.
• Lattice degeneration of the retina is a fairly common degenerative disease of the peripheral retina characterized by the presence of lattice lines created by fibrosed blood vessels.
• Crisscrossing fine white lines that account for the name lattice degeneration are present in roughly only 10% of lesions and most likely represent hyalinized blood vessels.