Abstract
Replicative turnover of the corneal epithelium is believed to occur from a population of stem cells located at the cor-neo-scleral limbus. During the healing of corneal epithelial wounds, sheets of epithelial cells move centripetally from the limbus and circumferentially along the limbus to cover the defect. A whorled or vortex pattern, similar to that seen in cornea verticillata, has been reported to occur on the corneal surface as an effect of topical steroid medication, during the healing of grafted corneas. This condition has been termed ‘hurricane keratopathy’. We have noted this appearance in 6 patients who did not have corneal grafts. In all our patients the whorled pattern was best visible on fluores-cein staining. This feature differentiates ‘hurricane keratopathy’ from cornea verticillata secondary to deposition of substances in corneal epithelial cells. Further, in all our patients the vortex was clockwise. Examination of illustrations of ‘hurricane keratopathy’ and cornea verticillata reported in the literature reveals that the whorled pattern is almost always clockwise. We believe that this specific pattern is likely to be due to the effect of the electromagnetic fields of the eye on the migrating epithelial cells and present a theory to explain this phenomenon. In 3 eyes of 2 other patients with chronic epitheliopathies we observed a random distribution of cells that did not conform to any specific pattern. We have termed this condition ‘blizzard keratopathy’.
Similar content being viewed by others
Article PDF
References
Mackman GS, Polack FM, Sydrys L . Hurricane keratitis in penetrating keratoplasty. Cornea 1983;2:31–4.
Lemp MA, Mathers WD . Corneal epithelial cell movement in humans. Eye 1989;3:438–45.
Fleischer B . (1910). Quoted by Bloch FJ. Vortex-shaped dystrophy of the cornea. Arch Ophthalmol 1940;23:825–8.
Bron AJ . Vortex patterns of the corneal epithelium. Trans Ophthalmol Soc UK 1973;93:455–72.
Dua HS, Forrester JV . Clinical patterns of corneal epithelial wound healing. Am J Ophthalmol 1987;104:481–9.
Thoft RA, Wiley LA, Sundarraj N . The multipotent cells of the limbus. Eye 1989;3:109–13.
Tseng SCG . Concept and application of limbal stem cells. Eye 1989;3:141–57.
Hanna C, O'Brien JE . Cell production and migration in the epithelial layer of the cornea. Arch Ophthalmol 1960;64:536–9.
Friedenwald JS, Buschke W . Some factors concerned in the mitotic and wound-healing activities of the corneal epithelium. Trans Am Ophthalmol Soc 1944;42:371–83.
Ebato B, Friend J, Thoft RA . Comparison of central and peripheral human corneal epithelium in tissue culture. Invest Ophthalmol Vis Sci 1987;28:1450–6.
Buck RC . Cell migration in repair of mouse corneal epithelium. Invest Ophthalmol Vis Sci 1979;18:767–84.
Kuwabara T, Perkins DG, Cogan DG . Sliding of the epithelium in experimental corneal wounds. Invest Ophthalmol Vis Sci 1976;15:4–14.
Dua HS, Forrester JV . The corneoscleral limbus in human corneal epithelial wound healing. Am J Ophthalmol 1990;110:646–56.
Duke-Elder S . In: System of ophthalmology: Normal and abnormal development, vol III, part 2, Congenital deformities. London: Henry Kimpton, 1964:531–3.
Bloch FJ . Vortex-shaped dystrophy of the cornea. Arch Ophthalmol 1940;23:825–8.
Berson EL . Electrical phenomena in the retina. In: Moses RA, editor. Adler's physiology of the eye and clinical applications. 7th ed. London: CV Mosby, 1981:507–9.
Nuccitelli R . Physiological electric fields can influence cell mobility, growth and polarity. In: Miller K, editor. Advances in cell biology, vol 2. Greenwich: JAI Press, 1988;213–34.
Robinson KR . The responses of cells to electrical fields: a review. J Cell Biol 1985;101:2023–7.
Soong HK, Parkinson WC, Bafna S, Sulik GL, Huang SCM . Movements of cultured corneal epithelial cells and stromal fibroblasts in electric fields. Invest Ophthalmol Vis Sci 1990;31:2278–82.
Blakemore R . Magnetotatic bacteria. Science 1975;190:377–9.
Kuterbach DA, Walcott B . Iron-containing cells in the honey bee. J Exp Biol 1986;126:389–401.
Walcott C, Gould JL, Kirschvink JL . Pigeons have magnets. Science 1979;205:1027–9.
Zoeger J, Dunn JR, Muller M . Magnetic material in the head of dolphin. Science 1981;213:892–4.
Barnothy MF, Sumegi I . Effects of magnetic field on internal organs and the endocrine system of mice. In: Barnothy MF, editor. Biological effects of magnetic fields, vol 2. New York: Plenum, 1969:103–26.
Moatamed F, Johnson FB . Identification and significance of magnetite in human tissues. Arch Pathol Lab Med 1986;110:618–21.
Kirschvink JL . Ferromagnetic crystals (magnetite?) in human tissues. J Exp Biol 1981;92:333–5.
Gass JDM . The iron lines of the superficial cornea. Arch Ophthalmol 1964;71:348–58.
Galaktionova GV . Nature of the cellular proliferation of the corneal epithelium of mice in various regimens of exposure to permanent magnetic fields. Vopr Kurortol Fizioter Lech Fiz Kult 1985;6:45–8.
Skrinnik AV . Effect of a permanent magnetic field on rep-arative post-traumatic regeneration of the cornea. Oftalmol Zh 1980;35:361–3.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dua, H., Watson, N., Mathur, R. et al. Corneal epithelial cell migration in humans: ‘Hurricane and blizzard keratopathy’. Eye 7, 53–58 (1993). https://doi.org/10.1038/eye.1993.12
Issue Date:
DOI: https://doi.org/10.1038/eye.1993.12
This article is cited by
-
Rational drug targeting in Acanthamoeba keratitis: Implications of host cell-protozoan interaction
Eye (1997)
-
Do transplanted corneal limbal stem cells survive in vivo long term? Possible techniques to detect donor cell survival by polymerase chain reaction with the amelogenin gene and Y-specific probes
Eye (1997)
-
Vortex keratopathy associated with ibuprofen therapy
Eye (1996)
-
Vortex or whorl formation of cultured human corneal epithelial cells induced by magnetic fields
Eye (1996)