Keratoglobus: An experience at a tertiary eye care center in India.
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Date
2015-03
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Abstract
Context: This study was carried out as a part of an internal audit and is the largest series of patients
having keratoglobus, published in the literature. Poor visual acuity of the patients indicates the blinding
nature of the disease. Aims: We report our experience with patients having keratoglobus at a tertiary eye
care center in India. Settings and Design: Retrospective study. Materials and Methods: We analyzed
adults and pediatric patients (<16 years) with keratoglobus, seen during 2008–2012. The age, gender,
consanguinity, presenting ocular signs, ocular and systemic associations, visual acuity, corneal topography,
and surgeries were documented. Results: Forty‑eight patients (mean age 22 ± 15 years, 31 males) having
keratoglobus were analyzed. 21 patients (42 eyes) were <16 years. Twelve eyes (16 events) had positive
history of trauma. The presenting clinical signs were corneal scars/scars of tear repair (15 eyes), hydrops,
healed and acute (14 eyes) and corneal or globe rupture (9 eyes). Best‑corrected visual acuity was >20/40 in
6/42 (14.3%) pediatric eyes and 15/53 (28.30%) adults. Visual acuity ranging from counting of fingers to no
light perception was noted in 20/53 (37.74%) adults and 21/42 (50%) pediatric patients; 13/20 (65%) with blue
sclera and 8/22 eyes (36.37%) without blue sclera. Vernal keratoconjunctivitis was present in one pediatric
patient. Choroidal osteoma, retinitis pigmentosa, and retinal detachment were present in adults. Surgeries
performed were corneal tear repair (5 eyes), tissue adhesive application (2 eyes), descematopexy (4 eyes) and
penetrating keratoplasty (PK ‑ 8 eyes: Three had post‑PK glaucoma, graft failure‑one eye, 4 patients wore
scleral lens ‑ prosthetic replacement of the ocular surface ecosystem). Conclusions: About 50% of pediatric
eyes (65% having blue sclera) had no functional vision. Trivial trauma was responsible for corneal rupture
indicating need for protective glasses. About 50% patients had post‑PK glaucoma though grafts were clear.
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Keywords
Adults, blue sclera, keratoglobus, management, pediatric patients
Citation
Rathi Varsha M, Murthy Somasheila I, Bagga Bhupesh, Taneja Mukesh, Chaurasia Mukesh, Sangwan Virender S. Keratoglobus: An experience at a tertiary eye care center in India. Indian Journal of Ophthalmology. 2015 Mar; 63(3): 233-238.