Case of progressive hyperopia due to flattening of cornea

Abstract

PurposeTo report a case that had a progressive decrease in the visual acuity caused by a progressive increase in the hyperopia due to a flattening of the cornea.ObservationsA 50-year-old woman complained of decreased vision in both eyes. Her decimal best-corrected visual acuity was 1.2 in the right and 0.5 in the left eyes, and the refractive error (spherical equivalent) was +3.75 diopters (D) for the right eye and +6.5 D for the left eye. Slit-lamp examinations showed clear corneas but Descemet‘s folds and fine pigmentations and opacities were present beneath the corneal epithelium in both eyes. Analysis of the corneal shape by anterior segment optical coherence tomography showed that the corneas were flattened, and the corneal refractive power was decreased in both eyes. The large values of the higher-order aberration in the cornea and total eye displayed bilateral irregular astigmatism. She obtained good vision by wearing hard contact lenses but her refractive power continued to decrease for at least 1 year.Conclusionsand Importance: We report a rare case of progressive hyperopia and irregular astigmatism due to a flattening of the cornea. Folds were present in Descemet‘s membrane but the cornea was not edematous.

A Study Linking Axial Length, Corneal Curvature, and Eye Axis With Demographic Characteristics in the Emmetropic Eyes of Bangladeshi People

“…In multivariate analysis, AL was significantly associated with a higher corneal curvature radius (p<0.001) and negatively associated with the lens vault (p<0.001), which is equally accountable for developing refractive error [ 57 ]. Multiple studies have reported that reducing or flattening corneal curvature promotes progressive hyperopia and corneal astigmatism [ 58 - 60 ]. Furthermore, no statistically significant association was found between Rt AL and the right axis; nonetheless, a significant association was observed between Lt AL and the left axis.…”

Netarsudil-Induced Corneal Flattening in a Child with Secondary Open-Angle Glaucoma

“…If corneal topography was measured, one might expect to observe central corneal flattening with relative steepening in the periphery and an abnormal prolate shape factor [ 7 ]. Anterior segment OCT might have revealed hyperreflective regions under the corneal epithelium and deep corneal stroma in the affected eye [ 8 ].…”

“…The main hypothesis for this mechanism of action conjectures that rho-kinase inhibitors may increase cell proliferation and adhesion within the corneal endothelium, hence decreasing apoptosis and promoting cell preservation [ 13 ]. If there was an excess of cell proliferation, however, this might induce stromal cells to abnormally secrete enzymes or proteins, such as TGFβ-induced proteins [ 8 ]. This could result in corneal fibrosis, thereby flattening the cornea [ 8 ].…”

“…If there was an excess of cell proliferation, however, this might induce stromal cells to abnormally secrete enzymes or proteins, such as TGFβ-induced proteins [ 8 ]. This could result in corneal fibrosis, thereby flattening the cornea [ 8 ]. It is worth considering how corneal flattening may fit within the proposed mechanism of action of rho-kinase inhibitors.…”