Chandler's disease

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Chandler's disease
X-ray showing avascular necrosis of the femoral head
Synonyms	Avascular necrosis of the femoral head
Pronounce	N/A
Specialty	N/A
Symptoms	Hip pain, limping, reduced range of motion
Complications	Osteoarthritis, hip joint collapse
Onset	Typically between ages 30 and 50
Duration	Chronic
Types	N/A
Causes	Idiopathic, trauma, steroid use, alcoholism
Risks	Corticosteroid use, alcohol abuse, trauma
Diagnosis	X-ray, MRI
Differential diagnosis	Osteoarthritis, hip fracture, septic arthritis
Prevention	N/A
Treatment	Conservative management, surgery
Medication	Pain management, bisphosphonates
Prognosis	Variable, depends on stage at diagnosis
Frequency	Rare
Deaths	N/A

A rare eye disorder affecting the corneal endothelium

Chandler's disease is a rare eye disease that is part of a group of disorders known as the iridocorneal endothelial syndrome (ICE). It primarily affects the corneal endothelium, leading to corneal edema and changes in the iris and anterior chamber angle, which can result in glaucoma.

Pathophysiology

Chandler's disease is characterized by an abnormality in the corneal endothelial cells. These cells, which normally maintain corneal transparency by pumping fluid out of the cornea, proliferate abnormally and migrate across the anterior chamber, leading to corneal edema. The endothelial cells in Chandler's disease have a "hammered silver" appearance when viewed under a slit lamp.

Clinical Features

Patients with Chandler's disease often present with blurred vision due to corneal edema. The disease is usually unilateral, affecting only one eye. Other symptoms may include halos around lights and mild eye discomfort. The iris may show atrophy, and the anterior chamber angle may be affected, leading to secondary glaucoma.

Diagnosis

Diagnosis of Chandler's disease is primarily clinical, based on the characteristic appearance of the corneal endothelium and associated symptoms. Gonioscopy may reveal peripheral anterior synechiae, and tonometry is used to assess intraocular pressure, which may be elevated due to glaucoma.

Treatment

The management of Chandler's disease focuses on controlling intraocular pressure and addressing corneal edema. Topical medications such as beta-blockers, carbonic anhydrase inhibitors, and prostaglandin analogs are commonly used to manage glaucoma. In cases where medical therapy is insufficient, surgical options such as trabeculectomy or glaucoma drainage devices may be considered. For corneal edema, hypertonic saline drops can be used to draw fluid out of the cornea. In advanced cases, corneal transplantation may be necessary to restore vision.

Prognosis

The prognosis for Chandler's disease varies. While some patients maintain good vision with treatment, others may experience progressive vision loss due to corneal decompensation or uncontrolled glaucoma.

See also

• Iridocorneal endothelial syndrome
• Corneal endothelium
• Glaucoma
• Corneal transplantation

Gallery

X-ray of idiopathic avascular necrosis of the femoral head

Necrotic bone and inflammation

Platelets collected by using apheresis

Stem cell syringe for regenerative medicine

Extracorporeal shock wave therapy for lateral epicondylitis

Hyperbaric oxygen therapy chamber