Aetiology of keratoconus.

Karseras, A G; Ruben, Montague

doi:10.1136/bjo.60.7.522

Cited by 160 publications

(75 citation statements)

References 2 publications

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“…Although keratoconic patients have a reputation of being 'difficult', 21 this did not appear to be the case with our patients. It is understandable that patients can be initially distressed in view of the debilitating visual loss affecting them at a rather young age.…”

Section: Discussioncontrasting

confidence: 37%

Characteristics and functional outcomes of 130 patients with keratoconus attending a specialist contact lens clinic

Lim

Vogt

2002

Eye

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Aims To evaluate the demographic profile, management and functional outcomes of patients with keratoconus attending the contact lens clinic of a tertiary ophthalmic referral centre over a one year period. Methods A retrospective cohort analysis was conducted by reviewing the computerised hospital records of 130 patients attending The Western Eye Hospital contact lens department over the period 1st Jan 1999 to 31st Dec 1999. Data on age, gender, referral pattern, visual acuity, contact lens fitting, degree of visual success, and some information on penetrating keratoplasty were obtained. Results 16.4% of all patients attending the Contact Lens clinic had keratoconus. The mean age at referral was 28.6 years and the mean age of keratoconus during the study period was 34.9 years. There was a predominance of male patients. Optometrists formed 72.2% of the referrals, and had prescribed some form of refractive correction in 70% of patients (two-thirds contact lenses) prior to hospital assessment. Of the 130 patients seen in the department during the study period, the post-referral management included bilateral contact lens fitting for 102 patients (78.5%), monocular contact lens fitting for 24 patients (18.5%) and no intervention in four patients (3%). The types of contact lenses used included PMMA lenses (2.7%), rigid gas permeable lenses (96.1%) of the spherical, elliptical and special cone lens designs, Keratosoft or Softperm lenses (0.8%) and scleral lenses (0.4%). Eleven eyes of eight patients had received penetrating keratoplasty (PK) prior to hospital assessment, of whom seven eyes needed post-surgical contact lens fitting. The main reasons for PK were contact lens intolerance (83%), frequent contact lens displacement (8.5%) and unsatisfactory visual acuity despite good contact lens fit (8.5%). Sixty-five per cent of patients were able to wear their contact lenses for more than 12 hours a day. With contact lens wear, 87% of patients had a visual acuity of 6/9 or better and 59% of eyes had improved visual acuity of 0.6 logMAR or more. Conclusion Optometrists were the main source of referral for keratoconus patients to the Hospital Eye Service (HES).The mean age at referral was 28.6 years, with a predominance of male patients. Blurred vision formed the main presenting visual symptom on initial hospital assessment; subsequently, more than two-thirds of patients required bilateral contact lenses. Rigid gas permeable contact lenses remain the mainstay treatment for advanced keratoconus, with various designs enabling a large proportion of patients to attain improved visual acuity.

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Section: Discussioncontrasting

confidence: 37%

Characteristics and functional outcomes of 130 patients with keratoconus attending a specialist contact lens clinic

Lim

Vogt

2002

Eye

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“…The overall average annual rate of kertoconus is 2.0 per 100.000 population (Krachmer et al, 1984). The cause of keratoconus is unknown, although some invesigators have reported for the clinical and demographic characteristics of patients with this condition (Krachmer et al, 1984;Woodward, 1981;Karseras and Ruben, 1976). Others have suggested a connection between the wearing of hard contact lenses and the development of a keratoconus (Harstein, 1968;Brightbill and Stainer, 1979;Gasset et al, 1978;Sommer, 1978).…”

Section: Discussionmentioning

confidence: 99%

The keratoconus epithelium studied by SEM

Jongebloed

Worst²

1987

Doc Ophthalmol

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A keratoconus removed from an 18-year-old male was processed for SEM and examined with special attention for the epithelial surface. A broad degenerative band was found running in the vertical meridian, showing areas devoid of, or with only partially attached, epithelial cells, and also areas with abnormal cells either, with a defective cell membrane and without cell contents or with an intact cell membrane but without a cell nucleus. Stereoscopic images of these defective cells show that cell degeneration is sometimes found several cell layers deep into the epithelium.

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“…Furthermore, AS patients may present with extraskeletal manifestations, such as ocular and cardiac abnormalities [4]. In this patient, either the previously bilateral keratoconus that required perforating keratoplasty, or the mitral prolapse, were attributable to MFS [1,11], whereas the mild aortic insufficiency might be attributable to both diseases [1,4].…”

Section: Discussionmentioning

confidence: 99%

Coexistent Marfan’s Syndrome and Ankylosing Spondylitis: A Case Report

Fietta

Manganelli

2001

Clin Rheumatol

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We report on a 46-year-old man with a 4-year history of predominantly nocturnal pain at the thoracic and lumbar spine as well as accompanying morning stiffness and episodes of alternating buttock pain. At physical examination the patient presented with the typical traits for Marfan's syndrome (MFS), along with limitation of both chest expansion and movement in all planes of the lumbar spine. Pelvic and lumbar spine radiographs showed findings consistent with ankylosing spondylitis (AS). Laboratory tests were consistent with an inflammatory state and HLA typing was positive for the B27 antigen. Transthoracic echocardiography showed prolapse of the posterior mitral leaflet and mild aortic insufficiency. We diagnosed co-existent MFS and AS. The association of these two pathologies is particularly interesting, owing to the co-existence of hypermobility of peripheral joints due to MFS ligamentous hyperlaxity, and the reduction of both axial skeleton motility and chest expansion related to AS. As both of these diseases may damage the cardiovascular system over time, follow-up with echocardiography monitoring is indispensable.

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Aetiology of keratoconus.

Cited by 160 publications

References 2 publications

Characteristics and functional outcomes of 130 patients with keratoconus attending a specialist contact lens clinic

Characteristics and functional outcomes of 130 patients with keratoconus attending a specialist contact lens clinic

The keratoconus epithelium studied by SEM

Coexistent Marfan’s Syndrome and Ankylosing Spondylitis: A Case Report

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