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Severe asymmetrical keratoconus with a thick cornea: a case report

Poster Details

First Author: R.Gonçalves PORTUGAL

Co Author(s):    J. Lemos   P. Rodrigues   C. Menezes   P. Coelho   B. Vieira   J. Serino

Abstract Details


To describe a particular case of a patient that developed an asymmetric severe keratoconus despite a thick cornea in both eyes.


Department of Ophthalmology, Hospital Pedro Hispano, Matosinhos, Portugal.


Case report.


A 14 year old boy presented with symptoms of blurred vision in his right eye since elementary school. His uncorrected visual acuity was 20/200 in the right eye and 20/20 in the left eye. Visual acuity in the right eye improved to 20/70 with a refraction of -15.00 -3.00x10º. Biomicroscopy of the right eye showed protusion in the inferior aspect of cornea, Vogt's striae, Fleischer's ring and a few corneal opacities. The left eye only had an incipient inferior cone. The steepest topographic keratometric readings were 63 diopters in the right eye and 52 diopters in the left eye. The corneal thickness was 512 µm in the right eye and 554 µm in the left eye. Due to the progression of keratoconus and little tolerance to contact lens the patient underwent intrastromal corneal ring segments implantation in the right eye. Afterward best corrected visual acuity was 20/100 in the right eye and remains stable in the left eye.


Keratoconus is a non-inflammatory corneal ectasia characterized by central thinning and steepening of the corneal curvature. The progressive nature of this disease leads to increased myopia and irregular corneal astigmatism, which decrease visual acuity and visual quality. Onset is often during the second decade of life onwards. Patients with keratoconus have notable between-eye asymmetry, and the degree of asymmetry is greater in cases of more severe disease, like in the presented case. It was also showed that keratoconus may develop despite a thick cornea, reinforcing the idea that biomechanical changes can signify an important factor in the development and progression of this pathology. FINANCIAL INTEREST: NONE

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