a case presentation of keratoconus

1. Clinical case presentation

2. Chief complaints
• Patient ABC , 17 year old complained of
diminution of vision in the LEFT EYE more than
RIGHT EYE since one year

3. HOPI
• Patient noticed of diminution of vision in the
left eye more than right eye since 1 year .
• It was gradually progressive
• History of frequent change of glasses present
• Not associated with any redness or eye pain
• No history of floaters or flashes of light

4. PAST HISTORY
• History of severe itching present perennially
with waxing and waning
• History of using OTC medication
• No history of any systemic illness
• No family history

5. PERSONAL HISTORY
• Diet – Mixed
• Appetite – normal
• Sleep – Normal

6. General examination
• Patient is moderately built and nourished,
conscious , co-operative and coherent
• No signs of Pallor , icterus, cyanosis, clubbing ,
lymphadenopathy or edema

7. Ocular examination
RIGHT EYE LEFT EYE
UCVA 6/60 1/60
BCVA 6/18 with
-2.50DS/-1.25DC@70deg
No further improvement
RETINOSCOPY Scissoring reflex + Scissoring reflex +
Eyelids Normal Munson sign +
Lacrimal Sac Normal Normal
Conjunctiva Upper tarsal cobblestone
papillae
Upper tarsal cobblestone
papillae
Sclera Normal Normal
Cornea Normal KC
Anterior Chamber Normal Normal
Iris Normal Normal
Pupil 3mmRRR 3mmRRR
Lens Clear Clear
Dilated fundus evaluation Normal Normal

8. • RIGHT EYE

9. • LEFT EYE

11. Diagnosis
• Bilateral Keratoconus LEFT EYE WORSE THAN
RIGHT EYE

12. Investigations
• RGP trial
• Corneal topography