This document discusses keratoconus, a degenerative condition characterized by thinning and steepening of the central cornea. It classifies keratoconus by severity from mild to severe based on diopter measurement. Symptoms include defective vision, photophobia, ghost images, and halos around lights. Diagnosis involves examination findings like scissor reflex on retinoscopy, irregular circles on Placido disc, and thinning/bulging of the central cornea on corneal topography. Management includes spectacle correction for mild cases, rigid contact lenses fitted with light central touch, and intracorneal ring segments or collagen cross-linking to halt progression. Surgery like lamellar or penetrating keratoplasty is indicated for

2.  It is degenerate non inflammatory condition of
cornea characterized by progressive thinning
and steepening of central cornea.

3.  BASED ON SEVERITY
A. Mild (less than 45D)
B. Moderate (45-50D)
C. Advance (52-62D)
D. Severe (more than 62D)

4. A. Nipple cone (small size < 5mm)
B. Oval cone (larger size 5-6mm)
C. Globus cone (very large > 6mm)

5.  Defective vision
 Photophobia
 Distorted vision
 Ghost mage
 Monocular diplopia
 Asthenopic symptoms
 Halos around lights

6.  On Retinoscopy – scissor reflex
 On Placido disc – irregular circle
 On keratometry – irregular mires and increased
power o cornea
 On Corneal topography –forme fruste
 On Silt –
 Thinning and bulging of central cornea
 Fleischer’s ring
 Munson’s sign – V shape profile of lower lid
when patent looks down

8.  Acute hydrops (due to rupture of descement
membrane)
 Corneal scaring

9. OPTCAL CORRETON
 SPECTACLE
 May improves vision in early stage

10.  Best choice
 Available contact lens;-
1. Rigid contact lens –
 Fitted with 3 point touch technique-
• Light central touch(2-3mm)at apex
• Another at periphery 3-9 o’clock position

11.  Specially designed contact lens in which optical
zone is reduced to fit the cone and peripheral
curve to fit irregular cornea.
 Fitted with light apical touch and optimal
peripheral clearance.
 Available in back toric, front toric and
peripheral toric.

12.  Rigid lens fitted on top of soft lens.
 Slight large area of apical touch acceptable.

13.  Made up of center rigid lens and periphery soft
lens.

14.  Indicated for advance case of keratoconus
where corneal lens do not work.
 It completely neutralizes corneal irregularity.

15.  Used in early stage of keratoconus (form fruste)

16. • Minimal apical touch or apical clearance.
• No excessive area of tear|debris pooling
beneath optical zone.
• Good circulation of tear film under lens.
• Good stability and comfort.
• Mild or moderate Dk lenses and good eye
wettability.

17. 1. Intact –
 Thin plastic semicircular rings inserted into the
medial layer of the cornea.
 Flattens cornea hence decreases progression.

18.  It is technique which uses UV light and
riboflavin as photosensitizer to strengthen
chemical bonds in the cornea hence halt the
progressive and irregularity of cornea.
3.Keratoplasty
o Lamellar keratoplasty
o Penetrating keratoplasty

19. ROJI MAHARJAN