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First Author: V.Kopayeva RUSSIA
Co Author(s): O. Kravchuk
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To demonstrate potential of keratoconus early diagnosis based on slit lamp signs of its early development and to trace further stages.
S. N. Fyodorov Eye Microsurgery State Institution, Moscow, Russia.
We possess many years clinical experience of follow-up and surgical treatment of patients with keratoconus (more than 50 years) which led to formulation of characteristic signs and symptoms of manifestation and further evolution of keratoconus.
Vision decrease, irregular astigmatism, frequent spectacles replacement, impossibility to correct sight with spectacles are characteristic features of clinical history. The first biomicroscopic sign is cornea apex displacement downwards in relation to pupil centre. This condition is described as diagnosis suspicion on keratoconus. Few months later the next biomicroscopic sign in the cornea centre is initial subtle folds in descemets membrane (Vogt lines). Now we set the diagnosis of keratoconus 1st stage. The process of keratoconus evolution might stop at this stage however more frequently it proceeds to next stages. 2nd stage is manifested with new folds and cracks in descemets membrane, cornea centre becomes thinned, downward apex displacement and anterior chamber deepening are sharply delineated. 3rd stage is characterized by intraocular fluid penetration into central corneal layers, the latter becomes thicker, translucent opacified foci appear. 4th stage proceeds with further stretching of the cornea and final formation of leucoma. Depending on stage parameters of visual acuity, refraction, central and paracentral corneal pachymetry, keratotopography change. Gradually pathological process involves all corneal layers.
Clear understanding of consecutive biomicroscopical signs of keratoconus evolution enables to diagnose the disease on early stages and to classify further development of the condition.