Materiały źródłowe

• #1 Keratoconus Diagnosis and Treatment: Recent Advances and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10511017/

  Keratoconus is a disorder characterized by progressive corneal thinning and steepening that may result in significant visual impairment secondary to high astigmatism, corneal scarring, or even corneal perforation. Early detection and screening of keratoconus are essential for effective management and treatment. Several screening methods, such as corneal topography and tomography, corneal biomechanics, and genetic testing, are being developed to detect keratoconus at an early stage. […] Early detection of keratoconus is tantamount to its proper treatment as timely intervention with progression prevention strategies, such as corneal collagen cross-linking (CXL), may help avoid more invasive treatments, such as full or partial thickness corneal transplantation. […] In this review, we discuss emerging innovations and needs surrounding keratoconus screening, prevention of disease progression, and treatment.

• #1  Understanding Keratoconus: Diagnosis and Treatment Options

  https://www.hilltopeyecenter.com/blog/understanding-keratoconus-diagnosis-and-treatment-options.html

  Keratoconus is an eye disorder that affects the cornea, the clear front surface of the eye, causing it to thin and bulge outward into a cone-like shape. […] Diagnosing keratoconus involves a series of eye examinations, often over several visits to your optometrist. […] If keratoconus is suspected, further tests, such as corneal topography (which maps the surface of the cornea) and optical coherence tomography (which provides a detailed view of the cornea’s layers), may be conducted. […] Another diagnostic tool is the slit-lamp examination, which involves shining a thin sheet of light into the eye while the doctor looks through a microscope. This test allows the doctor to look for signs of keratoconus such as corneal thinning, Fleischer rings (iron-colored rings surrounding the cornea), and Vogt’s striae (stress lines caused by corneal thinning).

• #1

  https://journals.lww.com/ijo/fulltext/2013/61080/imaging_modalities_in_keratoconus.8.aspx

  Diagnosis of keratoconus has greatly improved from simple clinical diagnosis with the advent of better diagnostic devices like corneal topographers based on placido disc, elevation based topographers and lately optical coherence tomography (OCT). […] These instruments are quite sensitive to pick up early keratoconus, which could help refractive surgeons to avoid serious complications like ectasia following keratorefractive surgeries. […] Currently, placido disc based topographers are the most commonly used topographers all over the world. […] Various quantitative indices based on these topographers have been suggested and validated by different authors to aid in the diagnosis and quantification of keratoconus. […] The clinical diagnosis of moderate to severe keratoconus is fairly easy when it presents with classical signs such as paracentral corneal thinning and protrusion, Vogt’s striae, Fleischer ring, and scissoring reflex on retinoscopy.

• #1 Keratoconus – EyeWiki

  https://eyewiki.org/Keratoconus

  Keratoconus is an uncommon corneal disorder where the central or paracentral cornea undergoes progressive thinning and steepening, causing irregular astigmatism. […] Diagnosis can be made by slit-lamp examination and observation of central or inferior corneal thinning. Computerized videokeratography is useful in detecting early keratoconus and allows following of its progression. Ultrasound pachymetry can also be used to measure the thinnest zone on the cornea. New algorithms using computerized videokeratography have been devised which now allow the detection of forme fruste, subclinical, or suspected keratoconus. […] Diagnosis is made based on the history of changing refraction, poor best spectacle-corrected vision, scissoring reflex on retinoscopy, and abnormalities in keratometry, corneal topography, and corneal tomography, in association with corneal thinning and inferior steepening; characteristic slit-lamp findings can often be seen.

• #1 Diagnosis – Keratoconus Specialists | Complete Family Eyecare

  https://www.keratoconusmn.com/diagnosis/

  Diagnosing Keratoconus. As with other ocular conditions, accurate diagnosis is the key to a proper treatment plan and best visual outcome. Keratoconus is often mistaken for other eye conditions or just poor vision which cannot be corrected with glasses or contact lenses. The first step in detecting possible keratoconus is measuring of the curvature of the cornea with a device called a keratometer. The curvature of the cornea or any other light bending surface such as eyeglass lenses, contact lenses, binocular lenses, etc., is measured in units called diopters. Higher diopters equates to a steeper cornea – simple as that. An “average” cornea will measure about 38 to 46 diopters in steepness. Any cornea from 46 to 49 diopters is considered suspicious for keratoconus and past 50 is assumed keratoconus. This is especially true if a significant difference (more than 3 diopters) exists between the vertical and horizontal curves of the cornea which is the measure of astigmatism. The next step is to determine the patients best corrected spectacle (glasses) vision through a refraction in which the best combination of corrective lenses to maximize vision is calculated. Even in the presence of steep corneas, if the vision is correctable to 20/20, the degree of keratoconus or irregular cornea is minimal. A strong indicator of keratoconus is visual acuity which cannot be corrected to 20/20 or with the patient still complaining of ghost images even with the best refraction in place. Any patient with steep corneas (over 48 diopters) and not correctable to a solid 20/20 with no other eye disease noted, should have a corneal topography mapping test performed. This test produces a topographical map of the cornea similar to that of any landscape map or elevation survey. The test is completely painless, requires no eyedrops or pupil dilation, and takes just a few seconds. In a normal cornea, the curvatures are relatively uniform across the whole mapping with curvatures under 45 diopters. In a keratoconus cornea, the curvatures very greatly throughout the cornea often showing an inferiorly decentered “cone” with curvatures usually past the 50 diopter level. The appearance of this steep cone confirms the keratoconus diagnosis. The corneal mapping is also a very valuable tool for following the progression of the keratoconus over time. Another recent advancement in keratoconus diagnosis is optical coherence tomography (OCT) which uses a scanning laser to image a cross section of the cornea. This allows doctors to look for the cone shaped cornea from a side view and also look for thinning of the cornea. OCT is a somewhat valuable tool but only looks through a cross section of the middle of the cornea. It usually does not pick up the cone shape of the keratoconus until it is well advanced making the corneal mapping a better diagnostic tool. However, the OCT is a fantastic device for determining the coverage of scleral contact lenses which are the best way to maximize vision in keratoconus patients. Once the diagnosis of keratoconus has been made, the most appropriate treatment options can be determined.

• #1 Keratoconus ,diagnosis and treatment | PPT

  https://www.slideshare.net/slideshow/keratoconus-diagnosis-and-treatment/119394034

  Rabinowitz diagnostic criteria for keratoconus include the following indices: K value – Measures central steepening of the cornea; a value of 47.20 D or greater suggests keratoconus. I-S value – Measures inferior-versus-superior corneal dioptric asymmetry; a value of 1.4 D or greater suggests keratoconus. KISA% – Incorporates K and I-S values with a measure quantifying regular and irregular astigmatism into a single index; a value in the range of 60-100% suggests keratoconus, and a value exceeding 100% strongly suggests frank keratoconus. […] Treatment usually starts with new eyeglasses, for visual improvement and astigmatism management. If eyeglasses don’t provide adequate vision, then contact lenses may be recommended. […] Corneal cross-linking involves administering riboflavin (vitamin B2) eye drops and UVA light in carefully selected parameters that strengthen the front layers of the cornea and avoid damage to the back part of the eye. Crosslinking is used to help stop the progression of keratoconus.

• #1 Keratoconus Screening in Primary Eye Care – A General Overview – touchOPHTHALMOLOGY

  https://touchophthalmology.com/anterior-segment/journal-articles/keratoconus-screening-in-primary-eye-care-a-general-overview/

  The most common classifications were the Amsler-Krumeich, and Collaborative Longitudinal Evaluation of Keratoconus (CLEK) classifications. […] Corneal tomography has been recognised as a critical diagnostic component in keratoconus patients assessment, helping in diagnosis (differentiating between fruste and clinical keratoconus) and monitoring progression, because it is necessary to confirm changes on the posterior corneal surface and corneal thickness alteration in order to diagnose (and monitor) keratoconus. […] In summary, corneal topography plays a significant role in keratoconus detection in primary eye care, because anterior Placido-based corneal topographers are cheaper devices with great utility in keratoconus management (fitting GP CL) and follow up. However, a definitive keratoconus diagnosis requires anterior and posterior corneal assessment (with corneal tomography and other techniques) and global pachymetry investigation able to distinguish between healthy cornea, fruste keratoconus and keratoconus. So, corneal tomography is compulsory to conduct a definitive diagnosis or in refractive surgery patients screening.

• #1 Keratoconus Diagnosis and Treatment: Recent Advances and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10511017/

  Corneal tomography is a technique that allows for three-dimensional visualization of the anterior and posterior corneal surfaces, along with assessment of corneal thickness. It has emerged as a promising screening tool in the identification of candidates for early corneal collagen cross-linking to prevent disease progression and more invasive surgical interventions. […] While significant correlations between average keratometry measures taken by corneal topography versus tomography were shown in the aforementioned study, others have found discrepancies in steep keratometry, flat keratometry, and average keratometry measurements between topography versus tomography in eyes with keratoconus. […] Thus, although the Amsler-Krumeich keratoconus classification system traditionally relies on anterior surface topography, further research is warranted to explore the use of a classification system that may rely on aspects of both corneal topography and tomography.

• #1 Community Eye Health Journal » Keratoconus: diagnosis and management

  https://archive.cehjournal.org/article/keratoconus-diagnosis-and-management/

  A definitive diagnosis of keratoconus is made using corneal topography and/or tomography. In settings where sophisticated imaging systems are not available, a simple Placido disk (or keratoscope) can be used. This reveals the shape of the front surface of the cornea (the topography) as a series of concentric rings (mires). In keratoconus, an irregular shape of the mires mirrors the irregular corneal curvature. An area of increased steepening is indicated where the reflected mires are close to each other. […] Two types of systems (available since the early 2000s) that can directly map the anterior and posterior surface of the cornea are Scheimpflug systems (e.g. Pentacam or Galilei) and scanning slit systems (e.g. Orbscan). These are generally more expensive. […] In patients with advanced keratoconus, corneal optical coherence tomography (OCT) can show thinning. A relatively new device (MS-39, CSO Italy) combines Placido disk corneal topography with high resolution OCT-based anterior segment tomography. This can segment corneal thickness into epithelium and stroma.

• #1 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://www.mdpi.com/2075-4418/13/16/2715

  Although several studies reported good sensitivity and specificity for distinguishing clinical KC from healthy cases using Placido with or without additional diagnostic modality, it is still challenging to detect subclinical or forme fruste cases and stratify them. […] AI was also used to diagnose and grade keratoconus patients using deep learning on color-coded maps obtained from Placido disk-based corneal topography. […] The Pentacam comprehensive eye scanner is one of the most popular devices for diagnosing glaucoma, power of IOL, cataracts, corneal ectasia, and KC. […] The topographic indices include the central keratoconus index (CKI), the keratoconus index (KI), the index of height asymmetry (IHA), the index of height decentration (IHD), the index of surface variance (ISV), the index of vertical asymmetry (IVA), minimal sagittal curvature (Rmin), and posterior elevation (PE).

• #1 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10453081/

  The Pentacam exhibits excellent intradevice precision but inconsistent inter-device repeatability. […] The topographic indices include the central keratoconus index (CKI), the keratoconus index (KI), the index of height asymmetry (IHA), the index of height decentration (IHD), the index of surface variance (ISV), the index of vertical asymmetry (IVA), minimal sagittal curvature (Rmin), and posterior elevation (PE). […] The Belin-Ambrsio enhanced ectasia display total deviation (BAD-D) value is a multivariate index that provides a global characterization of the cornea by integrating pachymetric and elevation data. […] The Galilei indices, except for posterior AAI, showed a low diagnostic accuracy for SKC but excellent diagnostic accuracy for KC. […] The accuracy of diagnosis is increased by recognizing the propensity toward AI, which goes above and beyond what is possible with plain quantitative indicators.

• #1 About Keratoconus – Keratoconus Australia – Keratoconus Australia

  https://www.keratoconus.org.au/about-kc/

  Keratoconus can be difficult to diagnose in the early stages as the initial symptoms can be associated with other eye conditions. A telltale sign as the disease advances is frequent changes in spectacle prescriptions and increasing complaints from the patient about their corrected vision. […] Keratoconus is usually diagnosed with a corneal topography, an ophthalmoscope, a retinoscope or a slit-lamp examination. The corneal topographer is the best instrument for detecting early keratoconus as it creates a computer-generated colored topographical map of the cornea that highlights the development of a cone. […] Measurements of corneal thickness are also useful for diagnosis. Corneal ultrasound or pachymetry can accurately measure the corneal thickness and can detect thinning that occurs in keratoconus. Normal corneal thickness is approximately 0.55mm (or about the thickness of a credit card).

• #1 Keratoconus Diagnosis: Unveiling the Hidden Culprit Behind Vision Problems | Laxmi Netralaya

  https://www.laxminetralaya.com/blog-details/how-is-keratoconus-diagnosed-

  Keratoconus is a degenerative eye condition that causes the cornea, the clear front part of the eye, to thin and bulge outward. […] The first step in diagnosing keratoconus is a comprehensive eye exam. This will include a review of your medical history, a vision test, and a slit-lamp exam. A slit-lamp exam is a microscopic examination of the eye that allows your eye doctor to view the cornea in detail. […] In addition to a slit-lamp exam, your eye doctor may also perform other tests to diagnose keratoconus, such as: Keratometry: This test measures the curvature of the cornea. Corneal topography: This test creates a detailed map of the corneal surface. Pachymetry: This test measures the thickness of the cornea. […] These tests can help your eye doctor to identify the characteristic signs of keratoconus, such as a cone-shaped cornea, thinning of the cornea, and irregular corneal curvature.

• #1 Practice Pearl of the Week: Keratoconus

  https://www.reviewofoptometry.com/email/051611_pearl54c.html

  A difference of 1.00D of astigmatism between the two eyes. Because keratoconus is an asymmetric, progressive condition, it’s not uncommon for one eye to progress faster than the other. And because corneal irregularity, such as astigmatism, is characteristic of keratoconus, a difference of 1.00D of astigmatism is a potential indicator. […] An unstable refractive error.

• #1 Community Eye Health Journal » Keratoconus: diagnosis and management

  https://archive.cehjournal.org/article/keratoconus-diagnosis-and-management/

  Early keratoconus is often characterised by epithelial thinning over the tip of the cone, with corresponding thickening around the base of the cone as the epithelium tries to mask the irregular stroma. […] Cross-sectional corneal OCT is also useful to assess the depth of the scar in patients with more advanced keratoconus with stromal scarring, who are due to undergo keratoplasty. […] The standard approach is to offer corneal cross-linking to patients who are progressing. Corneal changes should be greater than the limits of repeatability for your scanning device (i.e., above machine noise). […] Unfortunately, there is no consensus on what constitutes a significant change, but an increase in keratometry values of more than one dioptre, or a reduction in corneal thickness of greater than 15 microns, might be considered significant.

• #1 Keratoconus – EyeWiki

  https://eyewiki.org/Keratoconus

  Diagnostic procedures include the following: Slit-lamp examination, Retinoscopy (assessment of scissor reflex), Hard or gas-permeable contact lens trial, as improved vision with lenses eliminates other sources of poor vision, including amblyopia, Measurement of K values, Ultrasound pachymetry, Computerized corneal topography, Tear film biomarkers, like IL-6, TNF-, and MMP-9, which were overexpressed in tears of keratoconus patients, indicating pathogenesis of keratoconus might involve chronic inflammatory events, Computerized corneal tomography (rotating Scheimpflug, rotating slit-beam photography).

• #1 Keratoconus ,diagnosis and treatment | PPT

  https://www.slideshare.net/slideshow/keratoconus-diagnosis-and-treatment/119394034

  Keratoconus is a progressive eye disease where the cornea thins and bulges into a cone shape. It is diagnosed based on a patient’s visual complaints and examination findings showing corneal thinning and irregularity. […] Keratoconus is differentiated into mild, moderate, and advanced disease, as well as by shape. […] A history of multiple inadequate spectacle corrections of one or both eyes may be noted and may include oblique astigmatism on refraction as well as moderate-to-high myopia. […] One or more corneal signs of keratoconus are often present, as follows: Enhanced appearance of the corneal nerves is noted. Approximately 40% of eyes in patients with moderate keratoconus develop Vogt striae. Approximately 50% develop Fleischer ring. Approximately 20% develop corneal scarring. […] Corneal topography, OCT pachymetry, and diagnostic use of rigid contact lenses are sometimes required, especially when the typical biomicroscopy signs of Vogt striae and Fleischer ring are absent.

• #1  Diagnosing & Treating Keratoconus | Eye Doctor in Sunapee NH

  https://www.reedoptical.com/blog/diagnosing-and-treating-keratoconus.html

  Keratoconus is an eye condition that involves the bulging and thinning out of your cornea. According to the American Academy of Ophthalmology, keratoconus changes the shape of your cornea. This results in distorted and blurred vision in both your eyes. If you think you may have this progressive eye ailment, heres what you need to know about diagnosing and treating keratoconus. […] Your keratoconus diagnosis starts with a consultation. Here, your eye specialist will review your family and medical history. Next will be an eye exam, in which your eye doctor may subject you to other tests to gain more information about your corneas shape. The tests for diagnosing keratoconus are the following: […] Your eye doctor will conduct photographic tests like corneal topography and corneal tomography. These procedures aim to record images of your corneas general shape. […] The eye doctor focuses a vertical light beam on your eyes surface and then views your eye using a low-powered microscope. This test aims to determine the shape of your cornea and see if there are other eye issues present. […] Your eye specialist uses specialized equipment to measure your eyes and target any vision issues. […] During this test, your eye expert focuses a bright circle of light on each of your corneas. To determine the overall shape of your cornea, your eye doctor will measure the reflection of light.

• #1 Keratoconus Diagnosis and Treatment: Recent Advances and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10511017/

  Finally, recent studies have also explored the role of corneal epithelial thickness mapping to evaluate keratoconus progression. […] Corneal biomechanics attempts to characterize and predict changes in the corneal structure over time, and how these changes may impact vision. Corneal biomechanics has been important in understanding how surgery and other interventions impact the cornea and also may prove to be critical in improving screening and diagnosis of keratoconus. […] There have been recent advances in genetic testing that determines an individual’s risk of keratoconus. […] There is a pressing need for improved screening of pediatric and developmentally delayed patients for keratoconus. […] As the choice between the various treatment modalities for keratoconus largely depends on the level of disease severity, preventing keratoconus progression is the preferred management strategy.

• #1 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://www.mdpi.com/2075-4418/13/16/2715

  The Belin–Ambrósio’s enhanced ectasia display total deviation (BAD-D) value is a multivariate index that provides a global characterization of the cornea by integrating pachymetric and elevation data. […] The Galilei indices, except for posterior AAI, showed a low diagnostic accuracy for SKC but excellent diagnostic accuracy for KC. […] The Ocular Response Analyzer (ORA) consists of a metered air-pulse emitter, an infrared emitter, and a collimation detector that temporarily indent the cornea and concurrently measure the infrared reflectance of the ocular response. […] The Corvis ST (CST) is a non-contact tonometer that uses a Scheimpflug camera with 4330 frames per second to record the ocular response to an air pulse in an 8 mm wide horizontal section of the cornea. […] The accuracy of diagnosis is increased by recognizing the propensity toward AI, which goes above and beyond what is possible with plain quantitative indicators. […] Machine learning offers reliable and unbiased diagnosis, which is crucial when detecting patients early, as a closer follow-up or early intervention with treatments like corneal crosslinking (CXL) could prevent disease progression, reducing the need for a corneal transplant.

• #1 Differential Diagnosis of Keratoconus | Ento Key

  https://entokey.com/differential-diagnosis-of-keratoconus/

  An accurate diagnosis can often be made after consideration of corneal findings on slit lamp biomicroscopy, corneal tomography, and respectively generated keratoconus indices in relation to the ocular history, including details of contact lens wear and any prior corneal ablative or incisional procedure. […] Newer diagnostics such as epithelial thickness mapping, corneal aberrometry, and corneal biomechanical measurement such as with the Corvis ST (Oculus Optikgerte GmbH, Wetzlar, Germany) may help detect early ectatic disease. […] The differential diagnoses of keratoconus can be classified into other corneal ectatic diseases, and nonectatic conditions mimicking keratoconus. […] Corneal tomography is the gold standard for distinguishing between the two conditions. […] Several studies have investigated corneal hysteresis (CH) and corneal resistance factor (CRF) in patients with PMD. These showed that CH and CRF were also significantly decreased in PMD eyes, as in keratoconus, compared to healthy eyes.

• #1 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10453081/

  Various methods were described for detecting keratoconus (KC), primarily utilizing corneal topographers or tomographers. […] Due to the complex nature of KC, there is potential benefit in utilizing artificial intelligence (AI) approaches, including corneal biomechanical information, which already showed promise in forecasting the progression of keratoconus. […] This review provides a state-of-the-art assessment of the indices (both traditional and based on AI) used in early keratoconus detection. […] We aim to establish a multidimensional comparative network to assess the best KC diagnosis and management approach. […] Although several studies reported good sensitivity and specificity for distinguishing clinical KC from healthy cases using Placido with or without additional diagnostic modality, it is still challenging to detect subclinical or forme fruste cases and stratify them.

• #1 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10453081/

  The remarkable recent advances in managing keratoconus, the most common corneal ectasia, encouraged researchers to conduct further studies on the disease. […] Early detection plays a crucial role in facilitating less invasive treatments. […] This review encompasses corneal data ranging from the basic sciences to the application of artificial intelligence in keratoconus patients. […] Diagnostic systems utilize automated decision trees, support vector machines, and various types of neural networks, incorporating input from various corneal imaging equipment. […] Most of the studies reviewed herein demonstrate a high discriminatory power between normal and keratoconus cases, with a relatively lower discriminatory power for subclinical keratoconus. […] Finding an appropriate level of sensitivity is essential to screen mild or subclinical keratoconus (SKC) to prevent iatrogenic keratectasia after laser refractive surgery.

• #1 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10453081/

  AI was also used to diagnose and grade keratoconus patients using deep learning on color-coded maps obtained from Placido disk-based corneal topography. […] While the diagnosis of clinical KC had high accuracy, the accuracy was lower (86.8%) in subclinical keratoconus. […] Machine learning algorithms such as naive Bayes classifiers fed by Placido disc-based topographer corneal indices were successfully used in KC diagnosis as well. […] The SCORE is an AI-based analyzer that assists in the early diagnosis and follow-up of KC. […] The optimum cut-off, corresponding to zero, was established using a Receiver Operating Characteristics (ROC) curve, where positive and negative values represent a cornea with and without keratoconus, respectively. […] AI-based Orbscan analysis […] Several studies compared several machine learning approaches in terms of accuracy.

• #1 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10453081/

  Machine learning offers reliable and unbiased diagnosis, which is crucial when detecting patients early, as a closer follow-up or early intervention with treatments like corneal crosslinking (CXL) could prevent disease progression, reducing the need for a corneal transplant. […] We concluded that more accurate KC detection requires both clinical judgment enhancement and improving the quality of the machine learning algorithm.

• #1 Keratoconus Diagnosis Los Angeles – Conical Cornea OC

  https://www.lasereyecenter.com/keratoconus-treatment/

  Keratoconus can lead to distorted and blurred vision that can worsen over time. […] Historically, patients have had to wait until their eyesight quality has deteriorated before doctors can confidently diagnose keratoconus, but a new genetic test for keratoconus can now help patients seek treatment before permanently losing sight. […] The AvaGen test uses a simple cheek swab to collect a DNA sample from patients. […] A laboratory then analyzes this DNA for the presence of gene variants linked to keratoconus and other forms of corneal disease. […] After, doctors share this information with their patients, alerting them to any genetic links that necessitate them being hypervigilant about their corneal health. […] AvaGen genetic test for corneal disease is a smart choice for patients who have a family history of corneal problems, a thin or thinning cornea or a high level of astigmatism or nearsightedness. […] By having this genetic knowledge, patients can receive proactive care that may prevent some of the worst effects of keratoconus and corneal dystrophy.

• #1 Early diagnosis of keratoconus: what difference is it making? | British Journal of Ophthalmology

  https://bjo.bmj.com/content/98/11/1465

  The spectral-domain optical coherence tomography (OCT) (Spectralis, Heidelberg Engineering) provides details about the distribution of corneal epithelial and stromal thicknesses. […] The potential of Fourier Transform Infrared (FTIR) spectroscopy is combined with advanced chemometric processing of spectral data for the analysis of raw tears. […] The Optical Quality Analysis System, a double pass system (Visiometrics SL, Terrassa, Spain), has been used for the detection of keratoconus and subclinical keratoconus. […] The challenges we face in the future are treatments that increase the effectiveness in halting disease progression in asymptomatic subclinical stages and preserving visual quality and highly specific diagnostic equipment to avoid applying unnecessary treatments in false positives.

• #1 Differential Diagnosis of Keratoconus | Ento Key

  https://entokey.com/differential-diagnosis-of-keratoconus/

  Pertinent medical (systemic and ocular) and family history must be elicited. […] Many conditions can mimic keratoconus. These can be classified as ectatic and nonectatic disorders. […] Tomographic maps of both eyes must always be analyzed in relation to each other. In suspicious cases, repeat scanning may be done to confirm results. […] Newer imaging with biomechanics can help differentiate tomographic normal cases. […] Patients with equivocal findings must be followed up regularly with repeat corneal imaging. […] Keratoconus must be differentiated from other forms of keratectasia and other causes of irregular or asymmetric corneal astigmatism, because the management and prognosis are specific for each condition. Identifying underlying ectatic disease is also critical when screening candidates for laser refractive surgery, to avoid inadvertent acceleration of any underlying ectasia.

• #1 The Importance of Early Diagnosis of Keratoconus | Weston Contact Lens Institute

  https://www.westoncontactlens.com/early-diagnosis-keratoconus/

  Keratoconus, a progressive eye condition that causes the cornea to thin and bulge into a cone-like shape, can severely impact vision and quality of life. […] Early detection plays a pivotal role in improving outcomes. By identifying the condition at its onset, patients can benefit from timely interventions that slow progression and preserve vision. […] Despite its potential severity, keratoconus is often misdiagnosed in its early stages. […] Detecting keratoconus early is essential for several reasons. First, early diagnosis allows for the implementation of interventions that can halt or significantly slow the progression of the disease. […] Treatments like corneal cross-linking (CXL) are most effective when performed in the early stages of keratoconus. […] Early detection minimizes the risk of reaching this stage, preserving more treatment options for patients.

• #1 The Importance of Early Diagnosis of Keratoconus | Weston Contact Lens Institute

  https://www.westoncontactlens.com/early-diagnosis-keratoconus/

  Lastly, early diagnosis improves patients overall prognosis and quality of life. […] Advancements in technology have greatly improved the ability to diagnose keratoconus at its earliest stages. […] Combining these diagnostic methods ensures a comprehensive approach to identifying keratoconus as early as possible. […] Educating patients about the signs and risks of keratoconus is an integral part of promoting early diagnosis. […] Regular eye check-ups and vigilance in observing changes in a child’s vision or visual habits can make a significant difference in early detection. […] Corneal cross-linking is the gold standard for halting progression, particularly when performed early on. […] However, this invasive procedure can often be avoided with early diagnosis and proactive management.

• #1 The Importance of Early Diagnosis of Keratoconus | Weston Contact Lens Institute

  https://www.westoncontactlens.com/early-diagnosis-keratoconus/

  Early diagnosis of keratoconus not only improves short-term outcomes but also provides long-term benefits. […] By prioritizing regular eye exams, leveraging advanced diagnostic tools, and educating patients about the importance of timely intervention, eye care professionals can make a significant difference in the lives of those affected by keratoconus.

• #1

  https://journals.lww.com/ijo/fulltext/2013/61080/imaging_modalities_in_keratoconus.8.aspx

  Properly done laser-assisted in situ keratomileusis (LASIK) screening helps identify mild and forme fruste keratoconus which are known risk factors for post LASIK ectasia. […] Collagen cross-linking, with its promise of arresting progression, enhances the need for early diagnosis of keratoconus, before the cornea becomes too thin to cross-link. […] A variety of modern imaging modalities are available to diagnose subtle abnormalities in corneal curvature, thickness, and tissue architecture. […] Corneal topography, one of the most important diagnostic imaging tools for keratoconus, has evolved through placido based devices to slit scanning and Scheimpflug imaging devices. […] Newer devices such as Scheimpflug imaging and optical coherence tomography (OCT) are useful adjuncts in imaging these early indicators of keratectasia.

• #1 Community Eye Health Journal » Keratoconus: diagnosis and management

  https://archive.cehjournal.org/article/keratoconus-diagnosis-and-management/

  Early postoperative complications include poor epithelial healing, infective or sterile infiltrates, and central toxic keratopathy. […] It has become apparent that keratoconus is more prevalent than initially believed. Like many conditions, the focus has shifted from treating the disease to preventing and diagnosing it at an early stage. Corneal cross-linking has proven to be transformative in the management of progressive keratoconus, and it has led to a reduction in the need for corneal transplant surgery where it is being used.

• #1 Early diagnosis of keratoconus: what difference is it making? | British Journal of Ophthalmology

  https://bjo.bmj.com/content/98/11/1465

  Several indices have been developed to discriminate keratoconus and subclinical keratoconus from normal eyes, as well as progression, thus improving the sensitivity of these tests. […] Orbscan I (Bausch Lomb, Rochester, New York, USA) is an eye imaging instrument which uses slit scanning technology to provide wide-field pachymetry and anterior and posterior elevation maps as well as keratometry. […] Another surveyor, Pentacam (Oculus, Wetzlar, Germany), is based on the Scheimpflug principle, which provides a 3D mapping of the cornea from 25000 actual lifting points, including measurement of anterior and posterior surfaces of the cornea, corneal thickness and angle anterior chamber. […] This surveyor gives us an idea of the aberrations in eyes with keratoconus; there will be a significant increase in vertical coma, primary coma and coma aberrations.

• #1 Keratoconus Diagnosis and Treatment: Recent Advances and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10511017/

  For the most severe cases, DALK is another surgical procedure for visual rehabilitation. […] Keratoconus is a challenging disease to manage, and its progression can result in significant visual impairment and reduced quality of life for affected individuals. Early detection and screening allow for timely intervention and management to prevent disease progression.

• #2 Keratoconus: Innovations and Unmet Needs | OPTH

  https://www.dovepress.com/keratoconus-diagnosis-and-treatment-recent-advances-and-future-directi-peer-reviewed-fulltext-article-OPTH

  Keratoconus is a disorder characterized by progressive corneal thinning and steepening that may result in significant visual impairment secondary to high astigmatism, corneal scarring, or even corneal perforation. Early detection and screening of keratoconus are essential for effective management and treatment. […] Several screening methods, such as corneal topography and tomography, corneal biomechanics, and genetic testing, are being developed to detect keratoconus at an early stage. […] Early detection of keratoconus is tantamount to its proper treatment as timely intervention with progression prevention strategies, such as corneal collagen cross-linking (CXL), may help avoid more invasive treatments, such as full or partial thickness corneal transplantation. […] However, early diagnosis can be challenging using corneal topography as multiple parameters for diagnosis are often required.

• #2  Diagnosing & Treating Keratoconus | Eye Doctor in Sunapee NH

  https://www.reedoptical.com/blog/diagnosing-and-treating-keratoconus.html

  Keratoconus is an eye condition that involves the bulging and thinning out of your cornea. According to the American Academy of Ophthalmology, keratoconus changes the shape of your cornea. This results in distorted and blurred vision in both your eyes. If you think you may have this progressive eye ailment, heres what you need to know about diagnosing and treating keratoconus. […] Your keratoconus diagnosis starts with a consultation. Here, your eye specialist will review your family and medical history. Next will be an eye exam, in which your eye doctor may subject you to other tests to gain more information about your corneas shape. The tests for diagnosing keratoconus are the following: […] Your eye doctor will conduct photographic tests like corneal topography and corneal tomography. These procedures aim to record images of your corneas general shape. […] The eye doctor focuses a vertical light beam on your eyes surface and then views your eye using a low-powered microscope. This test aims to determine the shape of your cornea and see if there are other eye issues present. […] Your eye specialist uses specialized equipment to measure your eyes and target any vision issues. […] During this test, your eye expert focuses a bright circle of light on each of your corneas. To determine the overall shape of your cornea, your eye doctor will measure the reflection of light.

• #2  Understanding Keratoconus: Diagnosis and Treatment Options

  https://www.hilltopeyecenter.com/blog/understanding-keratoconus-diagnosis-and-treatment-options.html

  Keratoconus is an eye disorder that affects the cornea, the clear front surface of the eye, causing it to thin and bulge outward into a cone-like shape. […] Diagnosing keratoconus involves a series of eye examinations, often over several visits to your optometrist. […] If keratoconus is suspected, further tests, such as corneal topography (which maps the surface of the cornea) and optical coherence tomography (which provides a detailed view of the cornea’s layers), may be conducted. […] Another diagnostic tool is the slit-lamp examination, which involves shining a thin sheet of light into the eye while the doctor looks through a microscope. This test allows the doctor to look for signs of keratoconus such as corneal thinning, Fleischer rings (iron-colored rings surrounding the cornea), and Vogt’s striae (stress lines caused by corneal thinning).

• #2 About Keratoconus – Keratoconus Australia – Keratoconus Australia

  https://www.keratoconus.org.au/about-kc/

  Keratoconus can be difficult to diagnose in the early stages as the initial symptoms can be associated with other eye conditions. A telltale sign as the disease advances is frequent changes in spectacle prescriptions and increasing complaints from the patient about their corrected vision. […] Keratoconus is usually diagnosed with a corneal topography, an ophthalmoscope, a retinoscope or a slit-lamp examination. The corneal topographer is the best instrument for detecting early keratoconus as it creates a computer-generated colored topographical map of the cornea that highlights the development of a cone. […] Measurements of corneal thickness are also useful for diagnosis. Corneal ultrasound or pachymetry can accurately measure the corneal thickness and can detect thinning that occurs in keratoconus. Normal corneal thickness is approximately 0.55mm (or about the thickness of a credit card).

• #2 CRST Global | Improvements Needed in Keratoconus Diagnosis Criteria

  https://crstodayeurope.com/articles/2014-julaug/improvements-needed-in-keratoconus-diagnosis-criteria/

  Established criteria for detecting keratoconus progression in comparison with baseline measurements in contemporary clinical evaluation include the following: […] – Kmax (steepest K): 1.00 D increase; […] – Kmax Kmin (flattest K): 1.00 D increase; […] – Kmean (average of Kmax and Kmin): 0.75 D increase; […] – Pachymetry: 2% decrease in central corneal thickness; […] – Corneal apex power (measured with cone location and magnitude index): 1.00 D increase; and […] – MRSE change: 0.50 D. […] Several established decision trees exist based on combinations of the above criteria, such as the Klyce indices of surface asymmetry and surface regularity and the keratoconus percentage index.

• #2 Keratoconus: Innovations and Unmet Needs | OPTH

  https://www.dovepress.com/keratoconus-diagnosis-and-treatment-recent-advances-and-future-directi-peer-reviewed-fulltext-article-OPTH

  Corneal tomography is a technique that allows for three-dimensional visualization of the anterior and posterior corneal surfaces, along with assessment of corneal thickness. […] It has emerged as a promising screening tool in the identification of candidates for early corneal collagen cross-linking to prevent disease progression and more invasive surgical interventions. […] While significant correlations between average keratometry measures taken by corneal topography versus tomography were shown in the aforementioned study, others have found discrepancies in steep keratometry, flat keratometry, and average keratometry measurements between topography versus tomography in eyes with keratoconus. […] Further research is needed to explain the utility of corneal tomography over topography for earlier detection of keratoconus.

• #2 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://www.mdpi.com/2075-4418/13/16/2715

  The Belin–Ambrósio’s enhanced ectasia display total deviation (BAD-D) value is a multivariate index that provides a global characterization of the cornea by integrating pachymetric and elevation data. […] The Galilei indices, except for posterior AAI, showed a low diagnostic accuracy for SKC but excellent diagnostic accuracy for KC. […] The Ocular Response Analyzer (ORA) consists of a metered air-pulse emitter, an infrared emitter, and a collimation detector that temporarily indent the cornea and concurrently measure the infrared reflectance of the ocular response. […] The Corvis ST (CST) is a non-contact tonometer that uses a Scheimpflug camera with 4330 frames per second to record the ocular response to an air pulse in an 8 mm wide horizontal section of the cornea. […] The accuracy of diagnosis is increased by recognizing the propensity toward AI, which goes above and beyond what is possible with plain quantitative indicators. […] Machine learning offers reliable and unbiased diagnosis, which is crucial when detecting patients early, as a closer follow-up or early intervention with treatments like corneal crosslinking (CXL) could prevent disease progression, reducing the need for a corneal transplant.

• #2 What is Keratoconus: Diagnosis and Treatment

  https://www.dragarwal.com/blog/all-about-cornea/what-is-keratoconus/

  What are the tests for diagnosis of Keratoconus? […] Slit lamp examination: An examination to check your eyes for any abnormalities. […] Keratometry: It is a diagnostic instrument to measure the curvature of the anterior segment of the cornea, particularly for assessing the extent and axis of astigmatism. […] Corneal Topography: It is a method for obtaining three dimensional mapping of the surface of your cornea. […] Corneal Pachymetry: It is a test to measure the thickness of cornea.

• #2

  https://journals.lww.com/ijo/fulltext/2013/61080/imaging_modalities_in_keratoconus.8.aspx

  In addition to diagnosis of keratoconus, precise corneal imaging modalities such as OCT can also help in assessing the extent of ectasia, severity of thinning, and associated focal Descemet’s membrane irregularities. […] These help in planning and follow-up of surgical interventions such as collagen cross-linking and lamellar keratoplasty. […] The OCT is also a very useful tool in studying the optical characteristics of the cornea after surgical interventions such as collagen cross-linking. […] To summarize; a properly performed, good quality corneal topography is an excellent tool to diagnose keratoconus. […] The topographic indices can help us to detect and classify early and borderline cases of keratoconus. […] Newer, diagnostic devices like elevation based topographers and OCT can help us to visualize the posterior surface of cornea and can also give an accurate idea about the pachymetry of entire cornea. […] These newer modalities can help us diagnose keratoconus in preclinical stage, thus allowing an early treatment.

• #2 Keratoconus Diagnosis and Treatment: Recent Advances and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10511017/

  Finally, recent studies have also explored the role of corneal epithelial thickness mapping to evaluate keratoconus progression. […] Corneal biomechanics attempts to characterize and predict changes in the corneal structure over time, and how these changes may impact vision. Corneal biomechanics has been important in understanding how surgery and other interventions impact the cornea and also may prove to be critical in improving screening and diagnosis of keratoconus. […] There have been recent advances in genetic testing that determines an individual’s risk of keratoconus. […] There is a pressing need for improved screening of pediatric and developmentally delayed patients for keratoconus. […] As the choice between the various treatment modalities for keratoconus largely depends on the level of disease severity, preventing keratoconus progression is the preferred management strategy.

• #2 Diagnosing Keratoconus – Dr. Barry Leonard and Associates

  https://drbleonard.com/keratoconus/resources-for-doctors/diagnosing-keratoconus/

  Diagnosing Keratoconus […] When diagnosing Keratoconus in patients, knowing what to look for is crucial. These examples and images may help. […] You likely have a keratometer or topographer in your office, if not both. Irregular mires are an indicator of Keratoconus and other corneal dystrophies. You can use either instrument to see them. […] If you notice any of the above symptoms in your patients, you should consider testing for Keratoconus or other corneal dystrophies. […] When using a retinoscope, look for the scissors reflex, which is a scissoring motion during a retinoscopy. Since the scissor’s reflex changes based on the position of your instrument, it is difficult to portray it in a static image. See image D for a static illustration of the scissors reflex. […] The California Keratoconus Center is one of only 110 Optometrist practices worldwide and only 70 Optometrists in the USA to have the Eaglet Eye Surface Profiler (the “Keratoconus Machine”). We may also be one of only a half dozen who also have the Zeiss OCT and Nidek OPD III Wavefront Aberrometer, along with cooperative relationships with major lens manufacturers like ZenLens™, BostonSight™, ScanfitPro™ and others.

• #2 Keratoconus: Causes, Symptoms And Treatment | Diagnosis

  https://eyemantra.in/cornea/keratoconus-treatment/

  Getting a comprehensive eye exam can help ophthalmologists to determine keratoconus and can provide a better treatment option. […] Diagnosis of keratoconus is made through an eye exam in which an ophthalmologist will measure the curvature of the cornea and will compare it with the normal cornea. Change in the measurement will suggest that there has been a significant change in the shape of the cornea. Mapping the surface of the cornea can also help in studying its surface and the detailed image can provide a current condition of the surface of the cornea. […] Advanced techniques like refraction, keratometry, corneal topography, and slit-lamp examination helps to diagnose keratoconus. Refraction of light caused due to cornea helps in diagnosing keratoconus. Patients who have keratoconus have blurry vision, myopia, and irregular astigmatism. Correction of vision is difficult to obtain in such cases as there is a continuous need for a change of contact lenses and eyeglasses. Corneal topography is used when biomicroscopy cant determine the information related to keratoconus.

• #2 Keratoconus: Diagnosis, Screening, and Treatment | Neoretina

  https://neoretina.com/blog/keratoconus-screening-and-treatment/

  Keratoconus is bilateral and asymmetric ectatic eye condition which progresses until life’s fourth decade. […] Diagnosis of keratoconus is really challenging. Your ophthalmologist will have to conduct detailed eye examination and review your family and medical history. You will have to undergo various eye tests to determine details about the cornea shape. Some common screening tests to diagnose keratoconus include: […] Eye refraction: With the help of special tools and equipment, your ophthalmologist will check for eye and vision problems. […] Slit-lamp examination: A vertical beam of light is directed on the surface of your eye in this test to view the eye. […] Keratometry: In this test, your ophthalmologist will focus a circle of light on the eye cornea and measure the reflection. […] Computerized corneal mapping: Your eye doctor will carry out special photographic tests, like corneal topography and optical coherence tomography. These tests record thickness and take cornea images to create a detailed map of your cornea shape and surface.

• #2 Keratoconus: Innovations and Unmet Needs | OPTH

  https://www.dovepress.com/keratoconus-diagnosis-and-treatment-recent-advances-and-future-directi-peer-reviewed-fulltext-article-OPTH

  Minute changes in corneal shape can lead to clinically significant differences in optical measures of the eye. Corneal biomechanics attempts to characterize and predict changes in the corneal structure over time, and how these changes may impact vision. […] There have been recent advances in genetic testing that determines an individual’s risk of keratoconus. […] There is a pressing need for improved screening of pediatric and developmentally delayed patients for keratoconus. […] As the choice between the various treatment modalities for keratoconus largely depends on the level of disease severity, preventing keratoconus progression is the preferred management strategy. […] CXL is a minimally invasive procedure in which riboflavin, a photosensitizer, and ultraviolet-A light are used to induce the formation of strong chemical bonds between collagen fibrils in the cornea, thereby rendering it to be stiffer and less susceptible to ectatic changes.

• #2 Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review

  https://www.mdpi.com/2075-4418/13/16/2715

  Although several studies reported good sensitivity and specificity for distinguishing clinical KC from healthy cases using Placido with or without additional diagnostic modality, it is still challenging to detect subclinical or forme fruste cases and stratify them. […] AI was also used to diagnose and grade keratoconus patients using deep learning on color-coded maps obtained from Placido disk-based corneal topography. […] The Pentacam comprehensive eye scanner is one of the most popular devices for diagnosing glaucoma, power of IOL, cataracts, corneal ectasia, and KC. […] The topographic indices include the central keratoconus index (CKI), the keratoconus index (KI), the index of height asymmetry (IHA), the index of height decentration (IHD), the index of surface variance (ISV), the index of vertical asymmetry (IVA), minimal sagittal curvature (Rmin), and posterior elevation (PE).

• #2 The Importance of Early Diagnosis of Keratoconus | Weston Contact Lens Institute

  https://www.westoncontactlens.com/early-diagnosis-keratoconus/

  Lastly, early diagnosis improves patients overall prognosis and quality of life. […] Advancements in technology have greatly improved the ability to diagnose keratoconus at its earliest stages. […] Combining these diagnostic methods ensures a comprehensive approach to identifying keratoconus as early as possible. […] Educating patients about the signs and risks of keratoconus is an integral part of promoting early diagnosis. […] Regular eye check-ups and vigilance in observing changes in a child’s vision or visual habits can make a significant difference in early detection. […] Corneal cross-linking is the gold standard for halting progression, particularly when performed early on. […] However, this invasive procedure can often be avoided with early diagnosis and proactive management.

• #2 Multi-modal imaging for the detection of early keratoconus: a narrative review | Eye and Vision | Full Text

  https://eandv.biomedcentral.com/articles/10.1186/s40662-024-00386-1

  The timely identification of KC during its initial phases is of utmost importance, as delayed detection can diminish the efficacy of some therapeutic approaches, including spectacles and contact lenses. In addition, it is advisable to administer therapies such as corneal cross-linking at the earliest opportunity to mitigate the risk of additional corneal deformity and reduce the need for corneal transplantation. […] The assessment of KC is crucial in evaluating individuals who are being considered for refractive surgery, as there is a potential risk of iatrogenic corneal ectasia. […] Despite the array of corneal imaging techniques available for diagnosing established KC, detecting early cases of this disease presents a significant challenge. The accuracy of screening and diagnosis can be improved through the synergistic application of multiple techniques. In instances where KC is suspected, even in the absence of apparent abnormalities in one particular technique, clinicians are advised to employ additional diagnostic modalities, either independently or in conjunction. This approach proves beneficial for identifying patients at an earlier stage and reduces the risk of potential postrefractive ectasia. Ongoing advancements in these diagnostic modalities promise to contribute to a more comprehensive understanding and improved management of KC.

• #2 Keratoconus: Innovations and Unmet Needs | OPTH

  https://www.dovepress.com/keratoconus-diagnosis-and-treatment-recent-advances-and-future-directi-peer-reviewed-fulltext-article-OPTH

  For the most severe cases, DALK is another surgical procedure for visual rehabilitation. […] Keratoconus is a challenging disease to manage, and its progression can result in significant visual impairment and reduced quality of life for affected individuals. Early detection and screening allow for timely intervention and management to prevent disease progression.

• #3 Keratoconus – EyeWiki

  https://eyewiki.org/Keratoconus

  Keratoconus is an uncommon corneal disorder where the central or paracentral cornea undergoes progressive thinning and steepening, causing irregular astigmatism. […] Diagnosis can be made by slit-lamp examination and observation of central or inferior corneal thinning. Computerized videokeratography is useful in detecting early keratoconus and allows following of its progression. Ultrasound pachymetry can also be used to measure the thinnest zone on the cornea. New algorithms using computerized videokeratography have been devised which now allow the detection of forme fruste, subclinical, or suspected keratoconus. […] Diagnosis is made based on the history of changing refraction, poor best spectacle-corrected vision, scissoring reflex on retinoscopy, and abnormalities in keratometry, corneal topography, and corneal tomography, in association with corneal thinning and inferior steepening; characteristic slit-lamp findings can often be seen.

• #3 Keratoconus ,diagnosis and treatment | PPT

  https://www.slideshare.net/slideshow/keratoconus-diagnosis-and-treatment/119394034

  Keratoconus is a progressive eye disease where the cornea thins and bulges into a cone shape. It is diagnosed based on a patient’s visual complaints and examination findings showing corneal thinning and irregularity. […] Keratoconus is differentiated into mild, moderate, and advanced disease, as well as by shape. […] A history of multiple inadequate spectacle corrections of one or both eyes may be noted and may include oblique astigmatism on refraction as well as moderate-to-high myopia. […] One or more corneal signs of keratoconus are often present, as follows: Enhanced appearance of the corneal nerves is noted. Approximately 40% of eyes in patients with moderate keratoconus develop Vogt striae. Approximately 50% develop Fleischer ring. Approximately 20% develop corneal scarring. […] Corneal topography, OCT pachymetry, and diagnostic use of rigid contact lenses are sometimes required, especially when the typical biomicroscopy signs of Vogt striae and Fleischer ring are absent.

• #3 Keratoconus Screening in Primary Eye Care – A General Overview – touchOPHTHALMOLOGY

  https://touchophthalmology.com/anterior-segment/journal-articles/keratoconus-screening-in-primary-eye-care-a-general-overview/

  Keratoconus diagnosis is a challenge. Early stages of keratoconus, where clinical signs are not manifest on biomicroscopy (stromal thinning, conical protrusion, Fleischer corneal epithelial iron ring, Munson sign, Rizzuti sign, or Vogt striae) but the cornea demonstrates subtle topographic features comparable to those of clinical keratoconus receive the name of fruste keratoconus, subclinical keratoconus or keratoconus suspect. […] Clinical keratoconus is reliably detected with Placido disk-based corneal topography and even sometimes at slit-lamp examination. […] Currently, there is no clinically accepted classification allowing eyecare practitioners to clearly differentiate between healthy and keratoconus cornea (especially in early stages), and that could be used in patients follow-up in suspect (or diagnosed) cases.

• #3 Keratoconus Diagnosis: Expert Care at The Eye Foundation | Book Appointment Now!

  https://www.theeyefoundation.com/eye/keratoconus-diagnosis

  Corneal topography maps the cornea’s surface, revealing any irregularities or steepening that suggest keratoconus. […] Pachymetry measures the corneal thickness, identifying areas of thinning that may indicate keratoconus progression. […] Retinoscopy, a technique to assess refractive errors, can detect the irregular light reflection patterns characteristic of keratoconus. […] The earlier keratoconus is diagnosed, the sooner treatment can be initiated to slow its progression and preserve vision. At The Eye Foundation, our commitment to early detection and timely intervention empowers individuals with keratoconus to maintain clear vision and enjoy a fulfilling life. […] If you are experiencing vision changes or have a family history of keratoconus, please schedule a consultation with our keratoconus specialists at The Eye Foundation. We offer comprehensive diagnostic services and personalized treatment plans to address your unique needs and help you achieve clear, comfortable vision.

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