Oculodigital phenomenon leading to advanced keratoconus in Retinopathy of Prematurity – A case report

Abstract

A 14-year-old male child presented with complaints of poor vision in both eyes since infancy. The child had a history of preterm delivery, neonatal intensive care unit stay, and oxygen supplementation. He was diagnosed to have cicatricial Retinopathy of Prematurity [ROP]. Keratoconus was evident in both eyes, along with oculodigital sign and enophthalmos. This case highlights the grave sequelae of untreated ROP and its complications. A varied presentation of ROP is to be borne in mind when evaluating such patients later in life. Oculodigital sign can further compromise the vision in such cases due to associated keratoconus, cataract, and retinal detachment.

Association of torpedo maculopathy and keratoconus in a young patient: A multimodal imaging study

“…In this context, the connection with KC lies in the mechanical factor of eye rubbing, which predisposes children with visual impairments to the development of corneal ectasia. 15 Additionally, KC may be associated with acquired retinal, optic disc, and choroidal changes.…”

“…In this context, the connection with KC lies in the mechanical factor of eye rubbing, which predisposes children with visual impairments to the development of corneal ectasia. 15…”

Oculodigital Sign

“…Ocular auto-stimulation or oculodigital phenomenon has been described in children with LCA, retinopathy of prematurity, congenital rubella syndrome, Norrie’s disease, and severe vision impairment due to congenital causes such as cataract, glaucoma, corneal leucoma, and retinal degeneration. [ 4 ] Eye poking behavior may also be observed in children with severe intellectual disability despite the absence of vision impairment. [ 3 ] Oculodigital sign is observed frequently in young children with severe vision impairment of the above mentioned causes and disappears during adolescence.…”