Keratoconus Associated with Continual Eye Rubbing due to Punctal Agenesis

Lindsay, Richard; Bruce, A. J.; Gutteridge, Ian F

doi:10.1097/00003226-200007000-00034

Cited by 53 publications

(28 citation statements)

References 13 publications

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“…42 Within DUSKS 89% (CLEK reported 50.5% 1 ) of subjects reporting eye rubbing, almost half (48%) confirmed this occurred frequently or a great deal. Although DUSKS subjects tended to rub their eyes more frequently, this did not correlate with a significant association with the axial corneal power in these subjects, and hand dominance and steepness of the cone did not reveal any statistical correlation.…”

Section: Discussionmentioning

confidence: 92%

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

Weed

MacEwen

Giles

et al. 2007

Eye

231

164

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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: 92%

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

Weed

MacEwen

Giles

et al. 2007

Eye

231

164

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“…25 However, the force against the cornea is not the only parameter that distinguishes abnormal and normal rubbing. Case reports of rubbing that is not forceful but occurs frequently for many years and is associated with the development of keratoconus 26,27 suggest that the duration of rubbing habits can be an important factor. Equally, the frequency of rubbing can be important if the cornea does not get the chance to recover in the periods between rubbing episodes.…”

Section: Abnormal Rubbingmentioning

confidence: 99%

Abnormal Rubbing and Keratectasia

McMonnies

2007

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

115

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It appears reasonable to conclude that abnormal rubbing is a cause of some types of keratoconus, not because all abnormal rubbing, or only abnormal rubbing, leads to the development of some types of keratoconus, but because abnormal rubbing may increase the likelihood of the development of some forms of keratoconus. Abnormal rubbing habits may commence or continue after routine contact lens wear is established. Any associated rubbing or contact lens trauma may contribute to the progression of keratoconus. The abnormal rubbing-ectasia association in keratoconus may extend to other forms of keratectasia, including that seen after laser in situ keratomileusis, for which a contributory abnormal rubbing hypothesis may be appropriate.

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“…The association of albinism and KC was reported in a patient with bilateral KC associated with photophobia, positive family history for albinism and a history of frequent rubbing of the eyes [5], which has been put in relation with KC [6]. The locations of the TYR and VSX1 genes are on different chromosomes and hence are not expected to have common mutations, however, no association of VSX1 mutations with KC was found in a study performed on a large number of patients, hence, the genetic basis of KC requires further investigation [7].…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography for the Identification of a Rare Case of Keratoconus in Albino Donor Cornea

Elbadawy¹

2015

J Clin Res Ophthalmol

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A 61 years old albino donor cornea shows an association of a triple corneal pathologies, keratoconus, oculocutaneous albinism and neovascularisation. Optical coherence tomography (OCT) showed severe signs of keratoconus, corneal vascularisation and the presence of central leukoma. Keratoconus and corneal vascularisation in albino patients is a unique association, however, the genetic basis of this combination is still unclear. IntroductionKeratoconus (KC) is a corneal ectatic disorder characterized by irregular corneal surface elevation, interruptions in the Bowman's layer, stromal thinning and degeneration [1][2][3]. Irregular astigmatism and myopia can cause severe visual impairment. Oculocutaneous albinism (OCA) is a group of inherited disorders of melanin biosynthesis characterized by a generalized reduction in pigmentation of hair, skin and eyes. The inheritance pattern of albinism is autosomal recessive. Mutations in the tyrosinase [TYR] gene on chromosome 11 q14-q21 are reportedly common in most cases of OCA. The inheritance patterns of keratoconus are more complex than albinism due to the involvement of environmental factors in the incidence of KC. The most studied gene involved in KC is VSX1 gene, which is also involved in other corneal dystrophies [4]. Clinical manifestations of albinism include various degrees of congenital nystagmus, hypopigmentation and refractive errors, however, the association of albinism, keratoconus and corneal vascularisation were not reported previously. Case PresentationThe corneas from a 61 years old albino donor were recovered by The Veneto Eye Bank Foundation, Italy. The donor had a history of positive hypercholesterolemia and hypertension, and silent for corneal disorders. The cause of death was myocardial infarction. The autopsy revealed cardiac hypertrophy, myocardial diffuse sclerosis, hypoxic myocardial damage, outbreak of lymphocytic infiltration between cardiac myocytes, in multivessel coronary atherosclerosis plaques with regional myocardial ischemia and coronary spasm with critical stenosis of the left anterior descending branch. Pulmonary congestion and haemorrhagic alveoli with sub-acutemultiorgan stasis were also evident.The patient was heterochromic with green right and blue left eyes. The deceased was pseudophakic with KC in both eyes ( Figure 1a) and central leukoma (Figure 1b). Trypanblue ® staining was positive in few areas of the epithelium and the stroma near the centre of the cornea. The cornea from the right eye was usedfor OCT scanning. An abrupt incline of the corneal surface near the centre and thinning of the central stroma was noted (Figure 2). Additionally, vascularisation was evident behind the stromal haze (Figure 1c). The endothelium had large wrinkles and the leukoma was concentrated in the thinnest area of the cornea. DiscussionThe association of albinism and KC was reported in a patient with bilateral KC associated with photophobia, positive family history for albinism and a history of frequent rubbing of the eyes [5], which has b...

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Keratoconus Associated with Continual Eye Rubbing due to Punctal Agenesis

Cited by 53 publications

References 13 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

Abnormal Rubbing and Keratectasia

Optical Coherence Tomography for the Identification of a Rare Case of Keratoconus in Albino Donor Cornea

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