Corneal Ectasias

Question 1

Keratoconus

Answer 1

progressive thinning and anterior protrusion of a portion of central cornea

Question 2

Symptoms of Keratoconus

Answer 2

blurred vision

pain if Descemet’s ruptures (acute hydrops)

Question 3

Signs of Keratoconus

Answer 3

oil drop reflex with ophthalmoscopy
scissoring reflex w/ ret
Vogt Striae
Fleischer's Ring- iron deposits at base of cone
cone shaped cornea (Munson sign)

Question 4

Confirmation of Keratoconus

Answer 4

keratometry readings steeper than 50D

corneal topography

Question 5

Tx of Keratoconus

Answer 5

avoid eye rubbing
specialty CL- RGP
corneal cross linking
intracorneal implants- Intacs
keratoplasty- DALK

Question 6

Corneal Cross Linking

Answer 6

Riboflavin infused by light into cornea stops degradation or can fix keratoconus

Question 7

Acute Hydrops

Answer 7

sudden significant stromal edema due to a tear in Descemet’s membrane
causes severe pain

Question 8

Tx for Acute Hydrops

Answer 8

cycloplegia (for discomfort)
hypertonic saline- draws fluid out of epithelium
eventually resolves with scarring

Question 9

Pellucid Marginal Degeneration

Answer 9

progressive non-inflammatory thinning of inferior peripheral cornea

Question 10

Symptoms of Pellucid Marginal Degeneration

Answer 10

blurred vision

pain from acute hydrops

Question 11

Signs of Pellucid Marginal Degeneration

Answer 11

peripheral band of thinning from 4 to 8 o’clock

kissing birds on corneal topography

Question 12

Tx of Pellucid Marginal Degeneration

Answer 12

specialty CL
intrastromal rings
peripheral lamellar crescentic keratoplasty followed by central penetrating keratoplasty

Question 13

Keratoglobus

Answer 13

non-inflammatory corneal ectasia with diffuse thinning and protrusion

Question 14

Causes of Keratoglobus

Answer 14

congenital- Ehler-Danlos
acquired
defect in collagen synthesis

Question 15

Signs of Keratoglobus

Answer 15

globular shaped cornea
50- 60D on K readings
generalized thinning on pachymetry