Keratoconus
Definition
- Progressive conical protrusion of the cornea
- Starts at Puberty
- Weakness of central part (stroma weakness)Z
Incidence
- Atopy; chronic rubbingZ
- Bilateral
- +ve family history
Symptoms
-
Gradual decrease of vision
- Myopia (Curvature & Axial)
- irregular Astigmatism (many glass prescriptions)Z1
- Opacity at the apex of the cone
-
Sudden decrease of vision (Acute Hydrops i.e. acute oedema due to rupture of DM)
Signs of Keratoconus
-
Early
- Keratometer & corneal topography & pentacam
-
Late
- Cone shaped central cornea seen by Profile view
- Notching of the lower lid. on looking down → Manson’s signZ
- Deep opacity at the apex of the cone
- Rupture of BM & Folds of DM
- Fleischer ring: brown ring the cone base (hemosidren deposition)
Bilateral in 85% but asymmetrical
- Oil droplet reflex
- Vogt striae
- Prominent corneal nerves
- Bulging of lower lids on downgaze
- Fleischer ring & scarring
- Munson sign
- Acute hydrops
DD
- Keratectasia - Keratoglobus
Treatment
-
Early cases: Glasses, soft or hard CL
- Corneal Collagen Cross-linking with RiboflavinZ
- Intracorneal rings
-
Late cases: PK (penetrating keratoplasty)
manson’s sign
