ECTATIC,KERATOCONNUS

1. ECTATIC CONDITIONS OF CORNEA
SATISH REDDY A.N

2. CORNEAL ECTASIAS
1. Keratoconus
2. Keratoglobus
3. Keratotorus
(Pellucid marginal degeneration)

3. KERATOCONUS
• Is a non-inflammatory bilateral(85%) ectatic
condition of cornea (axial part)
• PUBERTY (early 20s)
• SLOWLY PROGRESSIVE

4. ETIOPATHOGENESIS
• Etiology of keratoconus remains unclear
• Theories – developmental condition, degenerative
condition, hereditary dystrophy, endocrine
anomaly
• Essential pathological changes – thinning and
ectasia ( defective synthesis of
Mucopolysaccharide and Collagen tissue)

5. CLINICAL FEATURES
SYMPTOMS
•Distorted and blurred vision
•Myopia (nearsightedness)
•Astigmatism
•Double vision
•Headaches due to eye strain
•Glare
•Light sensitivity

6. Signs of keratoconus
Placido disc examination
Vogt striae
Prominent corneal nerves
Bulging of lower lids
on downgaze
Fleischer ring & scarring
Munson sign
Acute hydrops

7. • Oil droplet reflex-
• Scissor reflex

8. Morphological classification of keratoconus
Nipple cone
Oval cone
Small and steep curvature
Larger and ellipsoidal
Globus cone
Largest

9. Ocular association
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Ectopia lentis
Congenital cataract
Aniridia
Retinitis pigmentosa
Vernal keratocongectivitis (VKC)

10. Systemic associations of keratoconus
Atopic dermatitis
Marfan syndrome
Down syndrome
Crouzon syndrome
Ehlers-Danlos
syndrome
Osteogenesis imperfecta

11. Treatment
• Spectacle correction
• Contact lenses – (rigid gas permeable)
• Intacts – intracorneal ring segmets

12. • Cornecollagen cross linkingal – may slow the
progression of disease
• Keratoplasty – (required in later stages )
DALK-deep anterior lamellar keratoplasty
PK-penetrating keratoplasty

13. Keratoglobus
Onset usually at birth (hereditary and congenital disorder)
• Bilateral protrusion and thinning of entire cornea
• Associations - Leber congenital amaurosis and blue sclera
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14. Pellucid marginal degeneration
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Onset between 20 and 40 years
•
Bilateral crescent-shaped inferior corneal thinning