A Guide to Clinical Contact Lens Management

Signs, Symptoms, Diagnosis and Management

Academy for Eyecare Excellence™
IN COOPERATION WITH
Centre for Contact Lens Research
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Keratoconus slit lamp
Keratoconus

Video: Keratonconus with Intacs and Soft Lens

Keratonconus with Intacs and Soft Lens

Keratoconus

Corneal distortion, irregular astigmatism, conical cornea

Symptoms

  • Blurry vision

Signs

  • Oval shaped distorted keratometric mires
  • Steepening of apical corneal curvature ≥47 D
  • Apex of cornea typically inferior and laterally displaced
  • Difference in corneal power ≥1.50D at locations 3mm above and below the visual axis
  • Cylindrical correction increasing / irregular astigmatism / poor spectacle acuity
  • Vogt’s striae (small centrally located striae)
  • Central scarring may occur, Kaiser Fleischer ring
  • Corneal topography shows inferior or central steepening (red area)

Etiology

  • Ectatic corneal disease in which cornea thins and distorts
  • Collagen disorder of cornea
  • Age of onset is usually teens to twenties

Prevalence

  • Occasional

Differential Diagnosis

Management

  • Fit with GP lenses to achieve good visual acuity
  • Monitor regularly for progression
  • A contraindication for refractive surgery
  • Frequently GP lens wear provides sufficiently good vision such that surgery can be avoided
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