Keratoconus Onset After Age 50

Tenkman, Lawrence R; Price, Marianne O.; Price, Francis W.

doi:10.3928/1081597x-20120522-02

Cited by 10 publications

(6 citation statements)

References 11 publications

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“…Untreated chalazia may induce corneal changes, which lead to a diagnosis of keratoconus suspect in an otherwise normal patient. Notwithstanding some exceptions, keratoconus normally has an early age of onset and findings of risk in a young patient may have less significance, when similar findings are found in an older patient. Older patients may have longer histories of contact lens wear with the increased possibility of residual alterations from pre‐contact lens wear findings.…”

Section: Discussionmentioning

confidence: 93%

“…Other factors relevant to prevalence include the age of those examined. Delayed onset until teenage or in some cases much later and even to the sixth decade suggests that prevalence should be higher with increasing age beyond the teen years. In the absence of symptoms, a delayed onset and diagnosis may represent a failure to examine for or detect changes due to early keratoconus, perhaps especially when methods based on recent technological advances were not or are not employed.…”

Section: Increasing Prevalence or Better Detection?mentioning

confidence: 99%

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Screening for keratoconus suspects among candidates for refractive surgery

McMonnies

2014

Clinical and Experimental Optometry

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This review examines methods for estimating the risk of post‐surgical ectasia in candidates for refractive surgery by establishing a diagnosis of keratoconus suspect as a contraindication for proceeding with surgery. Notwithstanding the desirability of achieving 100 per cent sensitivity, any associated reduction in specificity and increased numbers of false positives might deny some candidates the opportunity to proceed with refractive surgery. The introduction of a model for the risk of ectasia involving both pre‐ and post‐surgical findings has been followed by a plethora of attempts to achieve the same purpose based on topographic and/or tomographic evaluation before surgery. The desirability of being able to depend on objective assessment using one type of instrument needs to be weighed against the possibility that subjective assessments may contribute significantly to screening success. For example, consideration of ethnicity, family history of keratoconus, a history of atopy or ocular allergies in particular, a history of significant exposure to corneal trauma associated with abnormal rubbing habits or with vocational, leisure or geographically increased exposure to ultraviolet radiation or with contact lens wear trauma or a history of significant exposure to activities which elevate intraocular pressure may improve screening success. To the extent that these factors could contribute to increased risk of the development of keratoconus, they may be useful in estimating the risk of post‐surgical ectasia. If any combination of these factors helps to explain the development of keratoconus in normal or even thicker than normal corneas, they may have more significance for those corneas, which have been thinned surgically.

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Section: Discussionmentioning

confidence: 93%

Section: Increasing Prevalence or Better Detection?mentioning

confidence: 99%

Screening for keratoconus suspects among candidates for refractive surgery

McMonnies

2014

Clinical and Experimental Optometry

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“…Not all patients develop the disease in their youth, such as the reported onset in a patient aged 51 years. 36 During the years of progression and corneal changes the condition which may have begun in one eye only becomes bilateral in most, but not in all cases. In one study it was reported that 50% of the non-affected fellow eyes developed the disease within 16 years.…”

Section: Discussionmentioning

confidence: 99%

Effect of ageing on keratoconic corneas

Millodot

Ortenberg²,

Lahav-Yacouel³

et al. 2016

Journal of Optometry

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PurposeTo explore the potential effect of ageing on the corneal curvature and corrected visual acuity in patients with long-term keratoconus because of the paucity of these patients older than 50 years.MethodsRecords of keratoconic patients, who had initially presented to a specialized contact lens clinic and followed for more than 20 years after disease onset, were reviewed. Collected information included age, gender, date of first and last examination, date of onset of the disease, central corneal curvature, refraction, best corrected visual acuity (BCVA), therapeutic modality and clinical signs.ResultsAge of patients at last examination was 53.8 years ± 7.2 (range 44–67 years). Disease onset was self-reported to be at age 18.4 years ± 3.8. First examination was at age 25.1 years ± 9.4 and the mean number of years between first and last examination was 28.7 years. Mean central corneal curvature was 6.87 mm (48.77 D) ± 0.65 and 6.56 mm (51.09 D) ± 0.74, at first and last examination, respectively, a difference which was significant (p < 0.001). However, the last measurement of corneal curvature was found to remain approximately constant over the years from about 20 to 50 years after onset. Mean BCVA was not significantly different between first and last examination and was found to be approximately constant over the years.ConclusionCorneal curvature became steeper possibly within the first 20 years after disease onset but remained approximately unchanged afterwards. Likewise, BCVA remained practically constant over the years indicating relative stability of the disease after 20 years.

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“…Concerning its further ocular manifestations, a case report was presented by Tenkman et al of a fifty-plus female with definite keratoconus (KC)-an ectatic disorder of the cornea which produces progressive thinning-in the one eye and a possible KC in the fellow eye [14]. The patient was without a family history of KC or any connective tissue disease for that matter other than FM [15].…”

Section: Fibromyalgia (Fm)mentioning

confidence: 99%

Ocular manifestations of rheumatic diseases

Kemény-Beke

Szodoray

2019

Int Ophthalmol

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Purpose Our aim was to summarize key aspects of the pathomechanism and the ocular involvements of rheumatic and systemic autoimmune diseases. Methods Apart from a paper in French (Morax V, Ann Oculist 109:368-370, 1893), all papers referred to in this article were published in English. All the materials were peer-reviewed full-text papers, letters, reviews, or book chapters obtained through a literature search of the PubMed database using the keywords ocular manifestations; pathogenesis; systemic inflammatory rheumatic diseases; rheumatoid arthritis; osteoarthritis; fibromyalgia; systemic lupus erythematosus; seronegative spondyloarthritis; ankylosing spondylitis; reactive arthritis; enteropathic arthritis; psoriatic arthritis; systemic sclerosis; polymyalgia rheumatica and covering all years available. Some statements articulated in this paper reflect the clinical experience of the authors in their tertiary-referral center. Results Ophthalmic disorders are categorized by anatomical subgroups in all rheumatic diseases. The most common ocular manifestations are diverse types of inflammations of different tissues and dry eye disease (DED). Conclusion The eye could be a responsive marker for the onset or aggravation of an immune reactivation in many rheumatic diseases, furthermore, ocular findings can antedate the diagnosis of the underlying rheumatic disease. By recognizing ocular manifestations of systemic rheumatic diseases it might be possible to avoid or at least delay many long term sequelae.

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Keratoconus Onset After Age 50

Abstract: Although rare, ectatic changes can occur later in life without prior surgery or trauma. The patient has shown early signs of improvement with CXL despite her age.

Cited by 10 publications

References 11 publications

Screening for keratoconus suspects among candidates for refractive surgery

Screening for keratoconus suspects among candidates for refractive surgery

Effect of ageing on keratoconic corneas

Ocular manifestations of rheumatic diseases

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