Band Keratopathy

What is band keratopathy?

Band keratopathy is a disease of the cornea of your eye. Keratopathy is a term for many conditions that affect your cornea. Your cornea is normally a clear dome. If you have band keratopathy, you have calcium deposits in some layers of your cornea.

Calcium, in the form of calcium salts, collects into a belt shape that typically starts on the outside of your cornea (peripheral) and moves toward the middle (center). The deposits collect as your cornea breaks down. This can happen if you have an eye disease or an illness, like an immune system disorder, that affects your entire body.

Other names for band keratopathy include band-shaped keratopathy (BSK), corneal band keratopathy and calcific band keratopathy.

How does band keratopathy affect my body?

Band keratopathy affects your cornea, which is normally clear and transparent. The calcium buildup makes it murky and dull.

When the deposits get thick enough, they can scratch your eyes. You may feel band keratopathy before you see it. Over time, this condition can cause low vision.

The calcium is normally located in the area of your eye that’s visible to other people when your eyes are open.

What are the signs and symptoms of band keratopathy?

Signs and symptoms of band keratopathy include:

• Blurred vision.
• Eye pain if some of the deposits break off and scrape your eye.
• Eye irritation or feeling like you have sand or grit in your eye. (A name for this is foreign body sensation.)
• Intolerance to light (known as photophobia).
• Red eye.
• A visible change in the way that your eye looks. (Your provider will see a white-gray band, possibly with spots that look like holes, during a slit lamp eye exam.)

What causes band keratopathy?

You can get band keratopathy when the calcium levels in your body are out of balance. Many conditions can cause band keratopathy. These include diseases that affect only the eye and diseases that affect your whole body.

Eye issues that can cause band keratopathy

Diseases of the eye that can cause band keratopathy include:

• Glaucoma: This condition, which involves optic nerve damage, can cause blindness.
• Keratoconjunctivitis: This term refers to inflammation of two parts of your eye, the cornea and the conjunctiva.
• Uveitis: This term refers to a group of diseases that cause red, swollen and painful eyes. It, too, can cause blindness if not treated.
• Phthisis bulbi: This is a serious condition of eye damage also known as end-stage eye.
• Eye injury: These can happen in accidents or falls.

Immune system disorders that can cause band keratopathy

Disorders of the immune system that cause band keratopathy include:

• Juvenile idiopathic arthritis: This autoimmune disease can affect any joint in your body.
• Sarcoidosis: This inflammatory disease commonly affects your lungs but can affect several organs.
• Discoid lupus: If you have this condition, you’ll have round patches of thick and inflamed skin on your face or ears.

Hypercalcemia can cause band keratopathy

You can have hypercalcemia (too much calcium in your blood) because you have other issues, including:

• Hyperparathyroidism: This condition refers to what happens when one or more of your four parathyroid glands secrete too much parathyroid hormone.
• Toxic levels of vitamin D.
• Paget’s disease: If you have this condition, your bones break down and regrow too quickly and too often.

Other diseases that can cause band keratopathy

Some other conditions that may cause band keratopathy include:

• Gout: This is a type of inflammatory arthritis related to uric acid crystals.
• Multiple myeloma. This is a rare type of blood cancer. Treatment can slow the disease but not cure it.
• Ichthyosis: There are more than 20 types of this skin disease.
• End-stage kidney disease: This refers to kidney failure, when the kidneys no longer filter your blood.
• Exposure to certain chemicals, including some medications.

How is band keratopathy diagnosed?

If you have symptoms, you may start with a primary care doctor or go right to an eye care specialist. They’ll begin by asking you about your medical history and your symptoms to find out the cause of the calcific band keratopathy and to rule out other diseases.

They’ll also want to test your blood for levels of different substances, including:

• Calcium.
• Phosphorus.
• Hormones.
• Blood urea nitrogen and creatinine (kidney function tests).

An eye care provider will do a thorough eye exam that’s likely to include a slit lamp examination.

How is band keratopathy treated?

Chelation is the name of the most common treatment for band keratopathy. Chelation is a method of getting minerals or metals to bind to another substance. This allows your body to remove the bonded material.

In this case, providers remove calcium deposits in your eye by applying ethylene-diamine-tetra-acetic acid (EDTA). Your provider may use a laser to get rid of any remaining pieces of calcium and to smooth the area of your eye that was treated. This part of the process is therapeutic keratectomy.

A provider generally does the procedure as an outpatient procedure (you can go home the same day) under local anesthesia.

Your eye will need special protection for about two weeks after the procedure. Your provider may do an amniotic membrane graft or give you a bandage contact lens. An amniotic membrane is a specific type of tissue. A bandage contact lens is a soft contact lens. Both options offer protection.

If you have band keratopathy because you have an underlying condition, providers will treat the underlying condition so you don’t develop more calcium deposits.

How can I reduce my risk of developing band keratopathy?

You may be able to reduce your risk of developing band keratopathy by managing your overall health and your eye health.

This can include:

• Managing chronic conditions like high blood pressure, high cholesterol or diabetes.
• Eating healthy foods.
• Getting regular activity.
• Reaching and maintaining a healthy weight for you.
• Having regular medical checkups as well as regular appointments with an eye care provider.

What can I expect if I have band keratopathy?

For most people with band keratopathy, the prognosis is good as long as the underlying condition is treated. It’s not enough just to remove the calcium deposits. Deposits can happen again if you don’t correct the problem that causes the calcium issues.

When should I see my healthcare provider?

It’s important to pay attention to your eyes and the rest of your body. If you notice that something isn’t quite right, like your vision has decreased or you have eye irritation that won’t go away, call your eye care provider. The sooner you get help, the better the outcome is likely to be.

A note from Cleveland Clinic

Healthcare providers are as concerned as you are about preserving your eyesight. That’s why it’s so important to contact a provider if you notice anything different about your eyes or problems with your vision. You can develop band keratopathy if you have certain eye diseases, immune system disorders or hypercalcemia. If you do, ask your provider about your risk of developing band keratopathy. Regular appointments with an eye care provider contribute to keeping your eyes healthy.