Between-Eye Asymmetry in Keratoconus

Zadnik, Karla; Steger-May, Karen; Fink, Barbara A.; Joslin, Charlotte E.; Nichols, Jason J.; Rosenstiel, Carol E.; Tyler, Julie; Yu, Julie A.; Raasch, Thomas W.; Schechtman, Kenneth B.

doi:10.1097/00003226-200210000-00008

Cited by 161 publications

(110 citation statements)

References 31 publications

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“…Ethnic differences in the prevalence of keratoconus have been well documented. 6,21 Keratoconus is usually a bilateral condition, 23 although asymmetrical, 24,25 with the second eye lagging about 5 years behind the first. 26 In DUSKS, 88.5% were found to exhibit bilateral keratoconus, usually asymmetrical in presentation (P ¼ 0.005).…”

Section: Discussionmentioning

confidence: 99%

The Dundee University Scottish Keratoconus study: demographics, corneal signs, associated diseases, and eye rubbing

Weed

MacEwen

Giles

et al. 2007

Eye

231

178

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Aim To investigate and correlate the corneal, refractive, topographic and familial characteristics of a large cohort with keratoconus. Methods Prospective observational study of 200 consecutive patients presenting with keratoconus during the 4 year-period 1997-2000. Subjects were examined at enrolment and at a final review. Data were collected on demographic characteristics, referral route, symptoms, refractive correction, eye rubbing, family history, medical history, slit-lamp biomicroscopic corneal signs, and computerized corneal topography. Results Mean age at enrolment was 30.9710.4 (range, 12.2-72) years (N ¼ 200, 62.5% male, 93% white Caucasian) with a 5% family history of keratoconus. Atopic diseases included asthma (23%), eczema (14%), and hay fever (30%). Only 9% wore contact lenses before referral. Mean follow-up was 1004 days 7282 (range, 390-1335) and 9.778.9 (range, 1.1-60) years from diagnosis. The mean simulated K1 corneal power at enrolment was 51.7475.36 (range, 42.59-67.32) D and 88.5% exhibited bilateral keratoconus. Fifty-three (15%) topographically confirmed cones exhibited no clinical corneal signs at presentation. At enrollment, 56% had a pachymetry o0.480 mm increasing to 77% at final review. Forty-eight percent of subjects reported significant eye rubbing and there was a highly statistically significant difference (two sample t-test P ¼ 0.018) between keratoconus and control groups. TMS-2 axial corneal power was strongly associated with corneal scarring and age at diagnosis. The size of the scarring effect was 2.2 D (95% confidence interval (CI) 1.34, 3.06). Conclusions This study provides an overview of a large population with keratoconus highlighting presenting features and clinical and topographic progression over a 4 year-period.

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Section: Discussionmentioning

confidence: 99%

The Dundee University Scottish Keratoconus study: demographics, corneal signs, associated diseases, and eye rubbing

Weed

MacEwen

Giles

et al. 2007

Eye

231

178

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“…[3] Baseline study findings demonstrated large between-eye differences in high-(7.30 +/− 6.83 letters correct) and low-contrast (8.53 +/− 7.51 letters correct), bestcorrected visual acuity, high-(9.03 +/− 8.40 letters) and low-contrast (9.43 +/− 7.88 letters), entrance visual acuity, spherical equivalent refractive error [15] For the flat keratometric reading, high-contrast, best-corrected acuity, spherical equivalent refractive error, and corneal scarring, the results suggested that the association between disease severity and asymmetry was stronger in patients with more advanced disease. [16] FDACL was more repeatable than keratometry in severe disease.…”

Section: Baseline Findingsmentioning

confidence: 96%

Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: Methods and findings to date

Wagner

Barr

Zadnik

2007

Contact Lens and Anterior Eye

280

205

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Purpose-To describe baseline and longitudinal findings of the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study.Methods-The CLEK Study is an eight-year, multi-center, natural history study of 1,209 patients with keratoconus who were examined annually for eight years. Its goals are to prospectively characterize changes in vision, corneal curvature, corneal status, and vision-specific quality of life.Results-CLEK Study subjects had a mean age at baseline of 39.3 +/− 10.9 years. At study entry, 65% of the patients wore rigid contact lenses, and 14% reported a family history of the disease. Subjects exhibited a seven-year decrease in high-(2.03 letters) and low-(4.06 letters) contrast, best-corrected visual acuity, with 19% demonstrating decreases of 10 or more letters in high-contrast, best-corrected acuity and 31% of subjects demonstrating decreases of 10 or more letters in low-contrast, best-corrected acuity in at least one eye. Subjects exhibited an average eight-year increase in corneal curvature of 1.60 D in the flat corneal meridian, with 24% demonstrating increases of 3.00 D or more. The eight-year incidence of corneal scarring was 20%, with younger age, corneal staining, steeper baseline corneal curvature, contact lens wear, and poorer low-contrast visual acuity predictive of corneal scarring. Data from the National Eye Institute Visual Function Questionnaire suggest that the effect of keratoconus on vision-specific quality of life is disproportionate to its low prevalence and clinical severity.Conclusion-Although we report measures of disease severity and visual function across the CLEK sample, clinicians can begin to envisage the course of keratoconus in individual patients by determining whether factors predictive of disease progression are present in those patients.

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“…34 Keratoconus was found to be associated with hand dominance in a case of monocular keratoconus in patient with bilateral eyerubbing. 35 A patient suffering from Tourette's syndrome with a compulsion to rub the eyes developed severe bilateral keratoconus and progressed to right eye phthisis in 4 years.…”

Section: Eye Rubbing As a Cause For Keratoconusmentioning

confidence: 96%

Eye Rubbing and Keratoconus: A Literature Review

Hawkes¹,

Nanavaty²

2014

International Journal of Keratoconus and Ectatic Corneal Diseases

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Keratoconus is a progressive corneal ectactic condition that can lead to visual loss. Despite being the most common cause for keratoplasty in the developed world the aetiology is unknown. It is thought to be multifactorial, with genetic and environmental factors implicated. The association of eye rubbing and pathogenesis of keratoconus has been well documented. In this review, we collate the existing literature and summarize the current knowledge of the role of eye rubbing in the pathogenesis of keratoconus.

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Between-Eye Asymmetry in Keratoconus

Cited by 161 publications

References 31 publications

The Dundee University Scottish Keratoconus study: demographics, corneal signs, associated diseases, and eye rubbing

The Dundee University Scottish Keratoconus study: demographics, corneal signs, associated diseases, and eye rubbing

Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: Methods and findings to date

Eye Rubbing and Keratoconus: A Literature Review

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