Editorial Page on Keratoconus

Total Page:16

File Type:pdf, Size:1020Kb

Editorial Page on Keratoconus Acta Scientific Ophthalmology Volume 1 Issue 3 November 2018 Editorial Editorial Page on Keratoconus Gowhar Ahmad* Department of Ophthalmology, University of Jammu and Kashmir, India *Corresponding Author: Gowhar Ahmad, Department of ophthalmology, University of Jammu and Kashmir, India. Received: October 23, 2018; Published: October 25, 2018 keratoconus is a degenerative disease characterised by non- 13. Mar fans - 14. Mitral valves prolapse syndrome fraction so patient presents with frequent changes in refraction inflammatory corneal ectasia their is progressive changes in re 15. Achondroplasia condition is usually bilateral more common at puberty with male 16. Topic dermatitis preponderance condition has base and apex of cone base is re- 17. Aniridia ferred to plauciod cornea and apex is referred to nipple cornea keratoconus is a visual disturbing disease and not a visual threat- 18. Cong cataracts ening disease complicated cases of this disease entity present as 19. ROP keratoglobus glaucoma and hydrops typical characterises of kera- Recent modalities in the treatment of keratoconus are toconus are 1. Crossed corneal linkage 1. Foods and ruptures in de smets membrane of cornea 2. Hybrid contact lenses 2. Munson’s sign that is distortion of lower lid margin 3. Customised contact lens caused by bulged corea when patient looks in downward 4. Scleral contact lens phase 5. Scleral contact lens 3. Fleisher’s ring which is brownish ring of hemosiderin at 6. Pegy contact lens base of cone 7. Intrastromal corneal ring 4. Enlarged or visible corneal nerves 8. lamellar keratoplasty. 5. Vogt strea which are present in post stroma of cornea dis- appear on pressing the cornea Associated conditions with keratoconus are as follows Volume 1 Issue 3 November 2018 1. Ectopia lentis © All rights are reserved by Gowhar Ahmad. 2. Blue sclera 3. Osteogenesis imperfecta 4. Severe rubbing of eyes 5. K c sicca 6. Pigmentosa 7. Vk conjunctivitis 8. Downs syndromes 9. Turners’ syndrome 10. Edanlos syndrome 11. Lebers amaurosis 12. Mental retardation Citation: Gowhar Ahmad. “Editorial Page on Keratoconus”. Acta Scientific Ophthalmology 1.3 (2018): 01..
Recommended publications
  • Case Report Descemet Stripping Endothelial Keratoplasty in a Patient with Keratoglobus and Chronic Hydrops Secondary to a Spontaneous Descemet Membrane Tear
    Hindawi Publishing Corporation Case Reports in Ophthalmological Medicine Volume 2013, Article ID 697403, 5 pages http://dx.doi.org/10.1155/2013/697403 Case Report Descemet Stripping Endothelial Keratoplasty in a Patient with Keratoglobus and Chronic Hydrops Secondary to a Spontaneous Descemet Membrane Tear Anton M. Kolomeyer1 and David S. Chu1,2 1 The Institute of Ophthalmology and Visual Science, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark,NJ07103,USA 2 Metropolitan Eye Research and Surgery Institute, 540 Bergen Boulevard, Suite D, Palisades Park, NJ 07650, USA Correspondence should be addressed to David S. Chu; [email protected] Received 4 March 2013; Accepted 7 April 2013 Academic Editors: S. M. Johnson and S. Machida Copyright © 2013 A. M. Kolomeyer and D. S. Chu. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To report the use of Descemet stripping endothelial keratoplasty (DSEK) in a patient with keratoglobus and chronic hydrops. Case Report. We describe a case of a 28-year-old man with bilateral keratoglobus and chronic hydrops in the right eye secondary to spontaneous Descemet membrane tear. The patient presented with finger counting (CF) vision, itching, foreign body sensation, and severe photophobia in the right eye. Peripheral corneal thinning with central corneal protrusion and Descemet mem- brane tear spanning from 4 to 7 o’clock was noted on slit lamp examination. The right eye cornea was 15 mm in the horizontal diam- eter.
    [Show full text]
  • Corneal Ectasia
    Corneal Ectasia Secretary for Quality of Care Anne L. Coleman, MD, PhD Academy Staff Nicholas P. Emptage, MAE Nancy Collins, RN, MPH Doris Mizuiri Jessica Ravetto Flora C. Lum, MD Medical Editor: Susan Garratt Design: Socorro Soberano Approved by: Board of Trustees September 21, 2013 Copyright © 2013 American Academy of Ophthalmology® All rights reserved AMERICAN ACADEMY OF OPHTHALMOLOGY and PREFERRED PRACTICE PATTERN are registered trademarks of the American Academy of Ophthalmology. All other trademarks are the property of their respective owners. This document should be cited as follows: American Academy of Ophthalmology Cornea/External Disease Panel. Preferred Practice Pattern® Guidelines. Corneal Ectasia. San Francisco, CA: American Academy of Ophthalmology; 2013. Available at: www.aao.org/ppp. Preferred Practice Pattern® guidelines are developed by the Academy’s H. Dunbar Hoskins Jr., MD Center for Quality Eye Care without any external financial support. Authors and reviewers of the guidelines are volunteers and do not receive any financial compensation for their contributions to the documents. The guidelines are externally reviewed by experts and stakeholders before publication. Corneal Ectasia PPP CORNEA/EXTERNAL DISEASE PREFERRED PRACTICE PATTERN DEVELOPMENT PROCESS AND PARTICIPANTS The Cornea/External Disease Preferred Practice Pattern® Panel members wrote the Corneal Ectasia Preferred Practice Pattern® guidelines (“PPP”). The PPP Panel members discussed and reviewed successive drafts of the document, meeting in person twice and conducting other review by e-mail discussion, to develop a consensus over the final version of the document. Cornea/External Disease Preferred Practice Pattern Panel 2012–2013 Robert S. Feder, MD, Co-chair Stephen D. McLeod, MD, Co-chair Esen K.
    [Show full text]
  • Megalocornea Jeffrey Welder and Thomas a Oetting, MS, MD September 18, 2010
    Megalocornea Jeffrey Welder and Thomas A Oetting, MS, MD September 18, 2010 Chief Complaint: Visual disturbance when changing positions. History of Present Illness: A 60-year-old man with a history of simple megalocornea presented to the Iowa City Veterans Administration Healthcare System eye clinic reporting visual disturbance while changing head position for several months. He noticed that his vision worsened with his head bent down. He previously had cataract surgery with an iris-sutured IOL due to the large size of his eye, which did not allow for placement of an anterior chamber intraocular lens (ACIOL) or scleral-fixated lens. Past Medical History: Megalocornea Medications: None Family History: No known history of megalocornea Social History: None contributory Ocular Exam: • Visual Acuity (with correction): • OD 20/100 (cause unknown) • OS 20/20 (with upright head position) • IOP: 18mmHg OD, 17mmHg OS • External Exam: normal OU • Pupils: No anisocoria and no relative afferent pupillary defect • Motility: Full OU. • Slit lamp exam: megalocornea (>13 mm in diameter) and with anterior mosaic dystrophy. Iris-sutured posterior chamber IOLs (PCIOLs), stable OD, but pseudophacodonesis OS with loose inferior suture evident. • Dilated funduscopic exam: Normal OU Clinical Course: The patient’s iris-sutured IOL had become loose (tilted and de-centered) in his large anterior chamber, despite several sutures that had been placed in the past, resulting now in visual disturbance with movement. FDA and IRB approval was obtained to place an Artisan iris-clip IOL (Ophtec®). He was taken to the OR where his existing IOL was removed using Duet forceps and scissors. The Artisan IOL was placed using enclavation iris forceps.
    [Show full text]
  • Insertion of Aqueous Shunt in Pedicatric Glaucoma
    1/29/2018 Challenges of Insertion of Aqueous shunt in paediatric glaucoma Ahmed Elkarmouty MD, FRCS Moorfields Eye Hospital London, UK Classification • Primary Childhood Glaucoma • A- Primary Congenital Glaucoma (PCG) 1: 10,000–18,000 • B- Juvenile Open Angle Glaucoma (JOAG) (5-35 ys,)1 : 50,000. • Secondary Childhood Glaucoma • A- Glaucoma associated with non-acquired ocular anomalies • B- Glaucoma associated with non- acquired systemic disease or syndrome • C- Glaucoma associated with acquired condition • D- Glaucoma following Cataract surgery 1 1/29/2018 Glaucoma associated with non- acquired ocular anomalies • Conditions with predominantly ocular anomalies present at birth which may or may not be associated with systemic signs • Axenfeld Reiger anomaly • Peters anomaly • Ectropion Uvae • Congenital iris hypolplasia • Aniridia • Oculodermal melanocytosis • Posterior polymorphous dystrophy • Microphthalmos • Microcornea • Ectopia Lentis ( et pupillae) • Persistent foetus vasculopathy Glaucoma associated with non- acquired systemic disease or syndrome predominantly associated with known syndrome, systemic anomalies present at birth which may be associated with ocular signs • Down Syndrome • Connective tissue disorder: Marfan syndrome, Weill- Marchesiani syndrome, Stickler syndrome • Metabolic disorder : Homocystenuria, lowe syndrome, Mucoploysacchroidoses • Phacomatoses: Neurofibromatoses, Sturge Weber, Klipple-Trenaunay- weber syndrome, Rubenstein Taybi • Congenital Rubella 2 1/29/2018 Glaucoma associated with acquired condition Conditions
    [Show full text]
  • Analysis of the Variety of Eye Impairments in Glaucoma Cases in Children and Adults
    https://doi.org/10.5272/jimab.2017234.1804 Journal of IMAB Journal of IMAB - Annual Proceeding (Scientific Papers). 2017 Oct-Dec;23(4) ISSN: 1312-773X https://www.journal-imab-bg.org Original article ANALYSIS OF THE VARIETY OF EYE IMPAIRMENTS IN GLAUCOMA CASES IN CHILDREN AND ADULTS Tsvetomir Dimitrov Clinical Department of Ophthalmology, First General Hospital for Active Treatment Sofia AD, Sofia, Bulgaria ABSTRACT: the causes for the occurrence of glaucoma remain Glaucoma is a disease, which results in definitive vi- unclarified. There are multiple theories for the occurrence sion reduction. The aim of this study is an analysis of the of the disease, which may be systematized in the follow- differences in eye impairments in connection with the pro- ing way: gression of glaucoma in different age groups (children and 1. The increased intraocular pressure (IOP) impairs adults). A documentary method of investigation of scien- the nerve cells of the retina and of optic nerve due to me- tific sources, based on clinical practice, is applied. The chanical compression. methodology of the study comprises investigation of causes 2. The increased intraocular pressure (IOP) com- and manifestations of the disease and its typology. The spe- presses the blood vessels, which feed the retina and optic cific variety in the manifestation of glaucoma is established nerve, and the compression causes changes related to the in children and adults. Excavation of the optic nerve oc- disturbed blood supply. curs in the adult persons, because the eyeball is already 3. The presence of low blood pressure and high IOP thickened, and collagen is dense.
    [Show full text]
  • Eleventh Edition
    SUPPLEMENT TO April 15, 2009 A JOBSON PUBLICATION www.revoptom.com Eleventh Edition Joseph W. Sowka, O.D., FAAO, Dipl. Andrew S. Gurwood, O.D., FAAO, Dipl. Alan G. Kabat, O.D., FAAO Supported by an unrestricted grant from Alcon, Inc. 001_ro0409_handbook 4/2/09 9:42 AM Page 4 TABLE OF CONTENTS Eyelids & Adnexa Conjunctiva & Sclera Cornea Uvea & Glaucoma Viitreous & Retiina Neuro-Ophthalmic Disease Oculosystemic Disease EYELIDS & ADNEXA VITREOUS & RETINA Blow-Out Fracture................................................ 6 Asteroid Hyalosis ................................................33 Acquired Ptosis ................................................... 7 Retinal Arterial Macroaneurysm............................34 Acquired Entropion ............................................. 9 Retinal Emboli.....................................................36 Verruca & Papilloma............................................11 Hypertensive Retinopathy.....................................37 Idiopathic Juxtafoveal Retinal Telangiectasia...........39 CONJUNCTIVA & SCLERA Ocular Ischemic Syndrome...................................40 Scleral Melt ........................................................13 Retinal Artery Occlusion ......................................42 Giant Papillary Conjunctivitis................................14 Conjunctival Lymphoma .......................................15 NEURO-OPHTHALMIC DISEASE Blue Sclera .........................................................17 Dorsal Midbrain Syndrome ..................................45
    [Show full text]
  • Abnormalities Affecting the Eye As a Whole 2 8 Congenital Corneal
    I Editors vi Contributors vii , About the Series viii Preface ix ) Acknowledgments x -t -t Abnormalities Affecting the Eye as a Whole 2 Judith B. Lavrich Anophthalmia 2 Microphthalmia 8 Nanophthaha 12 Typical Coloboma 14 8 Congenital Corneal Opacity 18 Bruce SchnalI and Michael J. Bartiss Sderocornea 18 Birth Trauma: Tears in Descemet's Membrane 20 Ulcer or Lnfection 22 Mucopolysaccharidosis 24 Peters' Anomaly 26 Congenital Hereditary Endothelial Dystrophy 28 Corneal Dermoid 30 Anterior Staphyloma 32 Wilson's Disease (HepatolenticularDegeneration) 34 Herpes Simplex Infection 36 Herpes Simplex Virus Epithelial Dendrite or Ulceration 38 Herpes SimplexVirus Corneal Stromal Disease 40 Herpes Zoster Ophthalmicus 42 Chickenpox 44 Limbal Vernal Keratoconjunctivitis 46 C-3 Glaucoma 48 A& Levin and Anya A. Trumler Primary Congenital or Infantile Glaucoma 48 Juvenile Open-Angle Glaucoma 52 Aphakic Glaucoma 55 Uveitic Glaucoma 58 Sturge-WeberSyndrome 62 m xii CONTENTS Congenital Ectropion Uveae 65 Aniridia 68 Posterior Embryotoxon 70 C- C- 4 Iris Anomalies 72 Michael J.Bartiss and BruceM. Schall Central Pupillary Cysts (Pupillary Margin Epithelial Cysts) 72 Aniridia 74 BrusbJield Spots 76 Ectopia Lentis et Pupillae 78 Heterochromia Iridis 80 Iris Coloboma 82 Iris Stromal Cysts 84 Juvenile Xanthogranuloma 86 Lisch Nodules 88 Melanosis Oculi (Ocular Melanocytosis) 90 Persistent Pupillary Membrane 92 Posterior Synechiae 94 Axenfeld-Rieger Anomaly 96 -5 Lens Anomalies 98 Jonathan H. Salvin and Hillary Gordon Congenital and Developmental Cataracts 98 Ectopia Lentis 102 Anterior Lenticonus 104 Posterior Lenticonus 106 Spherophakia 108 C- 6 Retinal Anomalies 110 Barry N. Wasserman,Anuradha Ganesh, Alex V Levin, Carol L. Shields, Jerry A. Shields, and Alok S.
    [Show full text]
  • An Operation for Congenital Ptosis by George Young
    Br J Ophthalmol: first published as 10.1136/bjo.8.6.272 on 1 June 1924. Downloaded from 272 THE BRITISH JOURNAL OF OPHTHALMIOI,OGY added plus lenses (eye being under atropin), J.2, fluently. This made her left eye equal, for distance, to her better eye, which is now getting worse owing to increased bulging, and will probably follow the course of the other one soon. R.V.: 6/36, c. -1.OD sph. + 3.50D cyl. 1550: 6/24 and J.5. Furthermore, it may be noted that the intraocular tension was now normal on the side of the iridectomy, while the right eye was hard, and I submitted it again to pilocarpin and bandage at night. I sent her home for a fortnight to feed up, take malt and cod liver oil and fats, and to take plenty of rest and recuperate. On July 8 the final result was: L.V.: 6/36, c.-5.OD sph. +3.50D cyl. 1600: 6/12 full, and -3.OD sph. and +3.50D cyl. J.2. Soon I shall tattoo the stellate leucoma with an artificial pupil. May 10, 1924. Since writing the above, some ten months ago, affairs have kept steady. There is no bulging of the left cornea or scar. I attempted tattooing at two sittings, and have considerably diminished the glare of the scar, but I refrain from risking the deep tattooing necessary for securing an imitation round black pupil, fearing to do harm. Glasses were prescribed and worn with comfort and great help, the vision being maintained as above.
    [Show full text]
  • Retinitis Pigmentosa Associated with Ectopia Lentis
    CLINICOPATHOLOGIC REPORTS, CASE REPORTS, AND SMALL CASE SERIES SECTION EDITOR: W. RICHARD GREEN, MD tion of the oil progressing through the In January 2001, glaucoma sur- Silicone Oil Egressing tube and histopathologic analysis of gery was needed to control elevated Through an Inferiorly the orbital tissue surrounding the ex- intraocular pressure (IOP). The eye Implanted Ahmed Valve truded silicone oil. was aphakic and had total traumatic aniridia. An Ahmed valve was im- Silicone oil use as an adjunct to com- Report of a Case. A 69-year-old white planted inferonasally in an attempt plicated vitreoretinal surgery is be- man lost his left eye to trauma at age to avoid the silicone oil bubble coming more frequent. Refractory 12 years. In September 2000, blunt (Figure 1 and Figure 2). The pa- glaucoma in these patients is com- trauma resulted in a lacerated eye- tient’s IOP responded well initially mon. Isolated reports have men- brow, scleral rupture, uveal prolapse, but rose subsequently to 30 mm Hg. tioned the possibility of silicone oil extrusion of his crystalline lens, reti- A bubble of silicone oil was wrap- migrating and/or obstructing the nal detachment, and suprachoroidal ping the tip of the tube (Figure 3). tube in the anterior chamber of Mol- hemorrhage in his right eye. A limited Silicone oil could be seen migrating teno implants (IOP, Costa Mesa, anterior chamber washout was per- through the Ahmed tube (Figure 4 Calif).1,2 This report describes a case formed at the time of the primary re- and Figure 5) and the bleb over the of intraocular silicone oil egressing pair.
    [Show full text]
  • Congenital Ectopia Lentis - Diagnosis and Treatment
    From THE DEPARTMENT OF CLINICAL NEUROSCIENCE, SECTION OF OPHTHALMOLOGY AND VISION, ST. ERIK EYE HOSPITAL Karolinska Institutet, Stockholm, Sweden CONGENITAL ECTOPIA LENTIS - DIAGNOSIS AND TREATMENT Tiina Rysä Konradsen Stockholm 2012 All previously published papers were reproduced with permission from the publisher. Published by Karolinska Institutet. Printed by Larserics Digital Print AB. © Tiina Rysä Konradsen, 2012 ISBN 978-91-7457-883-6 ABSTRACT Congenital ectopia lentis (EL) is an ocular condition, which typically causes a high grade of refractive errors, mainly myopia and astigmatism. These might be difficult to compensate for, especially in children, who might develop ametropic amblyopia. Surgery on ectopic lenses has previously been controversial, due to the risk of sight- threatening complications. In paper I we studied retrospectively visual outcomes and complications in children, who were operated for congenital EL, and who had en scleral-fixated capsular tension ring (CTR) and an intra-ocular lens (IOL) implanted at the primary surgery. Thirty-seven eyes of 22 children were included. Visual acuity (VA) improved in all eyes, and only few had persistent amblyopia at the end of the follow-up. A great majority of the eyes had postoperative visual axis opacification (VAO), which was expected, since the posterior capsule was left intact at the primary surgery. Two eyes required secondary suturing for IOL decentration. No eye had any serious complications such as retinal detachment, glaucoma or endophthalmitis. Congenital ectopia lentis is often an indicator of a systemic connective tissue disorder, and Marfan syndrome (MFS) is diagnosed in 70% of the cases. This genetic disorder affects basically all organ systems in the body, EL and dilatation of the ascending aorta being the cardinal signs.
    [Show full text]
  • Differences in Manifestations of Marfan Syndrome, Ehlers-Danlos Syndrome, and Loeys-Dietz Syndrome
    1/30/2019 Differences in manifestations of Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome Ann Cardiothorac Surg. 2017 Nov; 6(6): 582–594. PMCID: PMC5721110 doi: 10.21037/acs.2017.11.03: 10.21037/acs.2017.11.03 PMID: 29270370 Differences in manifestations of Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome Josephina A. N. Meester,1 Aline Verstraeten,1 Dorien Schepers,1 Maaike Alaerts,1 Lut Van Laer,1 and Bart L. Loeys 1,2 1Center of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; 2Department of Genetics, Radboud University Medical Center, Nijmegen, The Netherlands Corresponding author. Correspondence to: Bart L. Loeys. Center for Medical Genetics, University of Antwerp, Antwerp University Hospital, Prins Boudewijnlaan 43/6, 2650 Antwerp, Belgium. Email: [email protected]. Received 2017 Jul 1; Accepted 2017 Oct 9. Copyright 2017 Annals of Cardiothoracic Surgery. All rights reserved. Abstract Many different heritable connective tissue disorders (HCTD) have been described over the past decades. These syndromes often affect the connective tissue of various organ systems, including heart, blood vessels, skin, joints, bone, eyes, and lungs. The discovery of these HCTD was followed by the identification of mutations in a wide range of genes encoding structural proteins, modifying enzymes, or components of the TGFβ-signaling pathway. Three typical examples of HCTD are Marfan syndrome (MFS), Ehlers-Danlos syndrome (EDS), and Loeys-Dietz syndrome (LDS). These syndromes show some degree of phenotypical overlap of cardiovascular, skeletal, and cutaneous features. MFS is typically characterized by cardiovascular, ocular, and skeletal manifestations and is caused by heterozygous mutations in FBN1, coding for the extracellular matrix (ECM) protein fibrillin-1.
    [Show full text]
  • Isolated Ectopia Lentis
    Isolated ectopia lentis Description Isolated ectopia lentis is a condition that affects the eyes, specifically the positioning of the lens. The lens is a clear structure at the front of the eye that helps focus light. In people with isolated ectopia lentis, the lens in one or both eyes is not centrally positioned as it should be but is off-center (displaced). Isolated ectopia lentis usually becomes apparent in childhood. The lens may drift further off-center over time. Vision problems are common in isolated ectopia lentis. Affected individuals often have nearsightedness (myopia) and can have an irregular curvature of the lens or a structure that covers the front of the eye (the cornea), which causes blurred vision (astigmatism). They may also develop clouding of the lenses (cataracts) or increased pressure in the eyes (glaucoma) at an earlier age than other adults. In a small number of people with isolated ectopia lentis, tearing of the back lining of the eye (retinal detachment) occurs, which can lead to further vision problems and possible blindness. In individuals with isolated ectopia lentis, each eye can be affected differently. In addition, the eye problems vary among affected individuals, even those within the same family. Ectopia lentis is classified as isolated when it occurs alone without signs and symptoms affecting other body systems. Ectopia lentis can also be classified as syndromic, when it is part of a syndrome that affects multiple parts of the body. Ectopia lentis is a common feature of genetic syndromes such as Marfan syndrome and Weill-Marchesani syndrome. Frequency The prevalence of isolated ectopia lentis is unknown.
    [Show full text]