Medicine:Corneal ectatic disorders

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Corneal ectatic disorders or corneal ectasia are a group of uncommon, noninflammatory, eye disorders characterised by bilateral thinning of the central, paracentral, or peripheral cornea.[1]

Types

  • Keratoconus, a progressive, noninflammatory, bilateral, asymmetric disease, characterized by paraxial stromal thinning and weakening that leads to corneal surface distortion.[2]
  • Keratoglobus, a rare noninflammatory corneal thinning disorder, characterised by generalised thinning and globular protrusion of the cornea.[3]
  • Pellucid marginal degeneration, a bilateral, noninflammatory disorder, characterized by a peripheral band of thinning of the inferior cornea.[4]
  • Posterior keratoconus, a rare condition, usually congenital, which causes a nonprogressive thinning of the inner surface of the cornea, while the curvature of the anterior surface remains normal. Usually only a single eye is affected.
  • Post-LASIK ectasia, a complication of LASIK eye surgery.[5]
  • Terrien's marginal degeneration, a painless, noninflammatory, unilateral or asymmetrically bilateral, slowly progressive thinning of the peripheral corneal stroma.[6]

Diagnosis

Usually diagnosed clinically by several clinical tests. Although some investigations might needed for confirming the diagnosis and to differentiate different types of corneal ectatic diseases.

  • Corneal topography
  • Corneal tomography

Treatment

Treatment options include contact lenses and intrastromal corneal ring segments for correcting refractive errors caused by irregular corneal surface,[7][8] corneal collagen cross-linking to strengthen a weak and ectatic cornea,[9] or corneal transplant for advanced cases.

References

  1. "Corneal ectatic disorders (keratoconus and pellucid marginal degeneration)". American Academy of Ophthalmology. http://one.aao.org/bcscsnippetdetail.aspx?id=509158fd-490f-432f-bdce-55b4f31b100e. 
  2. Weissman, Barry A; Yeung, Karen K (2019-05-30). Keratoconus. http://emedicine.medscape.com/article/1194693-overview#showall. 
  3. Wallang, B S; Das, S (28 June 2013). "Keratoglobus". Eye 27 (9): 1004–1012. doi:10.1038/eye.2013.130. PMID 23807384. 
  4. Rasheed, Karim; Rabinowitz, Yaron (2018-12-24). Pellucid Marginal Degeneration. http://emedicine.medscape.com/article/1196382-overview#showall. 
  5. "Ectasia After LASIK". American Academy of Ophthalmology. http://eyewiki.aao.org/Ectasia_After_LASIK. 
  6. "Terrien marginal degeneration". American Academy of Ophthalmology. http://one.aao.org/bcscsnippetdetail.aspx?id=2a425fcf-a3b3-47b6-acf8-643b6a9f7f93. 
  7. Marsack, Jason D.; Parker, Katrina E.; Applegate, Raymond A. (December 2008). "Performance of Wavefront-Guided Soft Lenses in Three Keratoconus Subjects". Optometry and Vision Science 85 (12): E1172–E1178. doi:10.1097/OPX.0b013e31818e8eaa. PMID 19050464. 
  8. Marsack, JD; Parker, KE; Niu, Y; Pesudovs, K; Applegate, RA (November 2007). "On-eye performance of custom wavefront-guided soft contact lenses in a habitual soft lens-wearing keratoconic patient.". Journal of Refractive Surgery 23 (9): 960–4. doi:10.3928/1081-597x-20071101-18. PMID 18041254. 
  9. Avni-Zauberman, N; Rootman, DS (November 2014). "Cross-linking and intracorneal ring segments--review of the literature.". Eye & Contact Lens 40 (6): 365–70. doi:10.1097/icl.0000000000000091. PMID 25320956. 

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