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PURPOSE: To understand effect of Scleral lens on Keratoglobus cornea. CASE STUDY: Prospective Case Study METHOD: A 19-year old male diagnosed with RE Keratoglobus and LE Keratoconus was given a trial of Scleral contact lenses (Comfort- 15), to understand vision development and rehabilitation when no other corrective option was giving fruitful results for vision rehabilitation. Upon trial final lens was chosen with respect to comfort, vision improvement for distance and near and visual rehabilitation, and was dispensed lens with follow-up of 1-week, 1- month, 3-month & 6-months. RESULT: With final lens patient was comfortable with wearing hours of 10-12 hours comfortably with vision restoration to both eyes 6/6; N6 from RE 6/60 and LE 6/24; N10 both eyes. CONCLUSION: Scleral lenses have been proven to be better corrective option for keratoglobus and keratoconus.
ABSTRACT
RESUMEN Se presenta un caso clínico de un varón de 27 años de edad, con una ectasia corneal y presencia de queratoglobo en ambos ojos. La manifestación clínica fue disminución lenta y progresiva de la agudeza visual en ambos ojos y dolor en el ojo izquierdo. Al examen oftalmológico se constató hidrops corneal agudo en ojo izquierdo y otras complicaciones corneales, propias de esta anomalía. Se realizó un estudio oftalmológico que permitió un diagnóstico certero. Se aplicó la terapéutica correspondiente y se sugirieron otras opciones terapéuticas (AU).
ABSTRACT We present the clinical case of a male patient, aged 27 years, with corneal ectasia and keratoglobus in both eyes. The clinical manifestation was progressive and slow decrease of the visual acuity in both eyes and pain in the left eye. At the ophthalmologic examination, acute corneal hydrops was found in the left eye, and also other complications that are proper of this anomaly. An ophthalmologic study was carried out that lead to an accurate diagnosis. The correspondent therapy was applied and several therapeutic options were suggested (AU).
Subject(s)
Humans , Male , Adult , Atropine/therapeutic use , Vision Disorders , Corneal Diseases/diagnosis , Visually Impaired Persons , Corneal Perforation/prevention & control , Keratoconus/diagnosis , Visual Acuity , Corneal Topography , Eyeglasses , Keratoconus/congenital , Keratoconus/etiology , Keratoconus/drug therapy , Keratoconus/epidemiologyABSTRACT
Background: Global advances in ophthalmology have created a greater need for ocular parameters in differentclinical and diagnostic fields. One important ophthalmic parameter is the curvature of cornea which is commonlyneeded for intraocular lens power calculation before cataract and refractive surgery and helps ophthalmologistsin contact lens fitting, diagnosis of several eye conditions such as keratoconus, keratoglobus and Marfan’ssyndrome.Subjects and Methods: The data for the study were retrospectively collected from the case files of patients whohad undergone cataract surgery from January 2017 to July 2017 in a private eye hospital Raipur, Chhattisgarh.The data collected were horizontal & Vertical curvature of cornea which was done by manual keratometer forcalculating intraocular lens power (after applying various formulas) to be implanted during cataract surgery.Then by using various statistical methods the results were interpreted.Results: The total number of patients taken for the study were 600 and the total number of eyes were 600, out ofwhich 300 (50%) were males and 300 (50%) females, with the age ranging from 45 to 80 years. The mean cornealrefractive power for the total sample were K1 (vertically) 44.18±1.89D, K2 (horizontally) 44.74± 1.88D, rangesfrom 39 D to 51 D. Although corneal refractive power was slightly higher in female as compared to male but thedifference was not significant. The values were almost similar in right and left eyes.Conclusion: The analysis might provide normative data for curvature of cornea required for IOL calculation incataract patients of Chhattisgarh region. Data of the range will be useful as reference values in case the surgeryis to be done at high volumes in surgical camps in rural areas where biometry equipment may not be available.There were no significant differences noted between male and female, right and left eyes in central Indianpopulation.
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We aimed to describe congenital keratoglobus with blue sclera in two siblings with overlapping Marshall/Stickler phenotype. Two sisters (ages four and six) with bilateral high astigmatism were evaluated by slit‑lamp microscopy. Corneal topography and pachymetry maps were also obtained. Slit‑lamp examination revealed that both corneas were globular in shape with peripheral corneal thinning. Pachymetry maps showed diffuse corneal thinning. Two siblings had in common the features of keratoglobus, blue sclera, atypical face, hearing loss, and hypermobile joints. We tentatively diagnosed the sisters as having an overlapping Marshall‑Stickler phenotype based on clinical and radiological findings. Marshall‑Stickler syndrome may exist in the differential diagnosis of keratoglobus with blue sclera.
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Context: This study was carried out as a part of an internal audit and is the largest series of patients having keratoglobus, published in the literature. Poor visual acuity of the patients indicates the blinding nature of the disease. Aims: We report our experience with patients having keratoglobus at a tertiary eye care center in India. Settings and Design: Retrospective study. Materials and Methods: We analyzed adults and pediatric patients (<16 years) with keratoglobus, seen during 2008–2012. The age, gender, consanguinity, presenting ocular signs, ocular and systemic associations, visual acuity, corneal topography, and surgeries were documented. Results: Forty‑eight patients (mean age 22 ± 15 years, 31 males) having keratoglobus were analyzed. 21 patients (42 eyes) were <16 years. Twelve eyes (16 events) had positive history of trauma. The presenting clinical signs were corneal scars/scars of tear repair (15 eyes), hydrops, healed and acute (14 eyes) and corneal or globe rupture (9 eyes). Best‑corrected visual acuity was >20/40 in 6/42 (14.3%) pediatric eyes and 15/53 (28.30%) adults. Visual acuity ranging from counting of fingers to no light perception was noted in 20/53 (37.74%) adults and 21/42 (50%) pediatric patients; 13/20 (65%) with blue sclera and 8/22 eyes (36.37%) without blue sclera. Vernal keratoconjunctivitis was present in one pediatric patient. Choroidal osteoma, retinitis pigmentosa, and retinal detachment were present in adults. Surgeries performed were corneal tear repair (5 eyes), tissue adhesive application (2 eyes), descematopexy (4 eyes) and penetrating keratoplasty (PK ‑ 8 eyes: Three had post‑PK glaucoma, graft failure‑one eye, 4 patients wore scleral lens ‑ prosthetic replacement of the ocular surface ecosystem). Conclusions: About 50% of pediatric eyes (65% having blue sclera) had no functional vision. Trivial trauma was responsible for corneal rupture indicating need for protective glasses. About 50% patients had post‑PK glaucoma though grafts were clear.
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En este artículo de revisión se pretende determinar los radios de curvatura que se pueden presentar en patologías y en alteraciones corneales de carácter hereditario, genético o iatrogénico, tanto en córneas planas y en córneas curvas como la esclerocórnea, microcórnea, megalocórnea, queratocono, queratoglobo, miopía de curvatura y otros. Se hizo una revisión bibliográfica de artículos con la información necesaria para identificar las alteraciones corneales más frecuentes que se pueden presentar en pacientes con córneas planas y córneas curvas diferentes a las queratometria, consideradas medidas promedio comprendidas entre 42,00 y 45,00 D. Se concluyó que los pacientes con córneas planas presentaban una refracción corneal entre 20,00 D y 41,50 D, siendo 32,25 D el promedio encontrado en la revisión; en las córneas curvas se encontraron refracciones corneales entre 51,00 D y 59,75 D, con un promedio de 55,50 D.
In this review there was tried to determine the curvature radius present in some pathologies and corneal diseases of hereditary, genetic or iatrogenic character, in flat corneas and steep corneas as esclerocornea, microcornea, megalocornea, Keratoconus, keratoglobus, curvature myopia and others. An article review was made to identify frequent corneal alterations that can be found in patients with flat and steeper curves different from corneal measures average between 42.00 and 45.00 D. It was concluded that in the patients with on flat corneas the corneal refraction was from 20.00 D to 41.50 D being the average value in the review 32.25 D; in steeper corneas, corneal refractions were from.