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Circumscribed posterior keratoconus: case report.

B B Lonsberry¹, P Boyce

¹Southern College of Optometry, Memphis, Tennessee, USA.

Journal of the American Optometric Association

|February 17, 2000

Summary

Posterior keratoconus, a rare corneal condition, typically has minimal impact on vision. Severe visual impairment may necessitate penetrating keratoplasty, especially when not caused by other eye conditions like cataracts.

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Area of Science:

Ophthalmology
Corneal Surgery
Ocular Pathology

Background:

Posterior keratoconus is a rare condition characterized by posterior corneal thinning and stromal depression.
Its impact on visual acuity is variable and can be influenced by co-existing ocular or systemic conditions.

Observation:

A case report details an African-American woman with bilateral posterior keratoconus, stromal scarring, and an epithelial iron ring in one eye.
Corneal topography revealed distinct patterns of steepening and flattening in each eye.
The patient also presented with myopic degeneration and cataracts.

Findings:

Posterior keratoconus generally results in minimal visual impairment.
The observed case involved significant corneal irregularities and other ocular comorbidities.
Endothelial cell layers were intact, suggesting preservation of corneal health.

Implications:

In most cases, posterior keratoconus requires no specific treatment due to its minimal effect on vision.
Penetrating keratoplasty is a viable surgical option for severe visual defects directly attributable to posterior keratoconus.
Distinguishing the visual impact of posterior keratoconus from other conditions like cataracts is crucial for treatment planning.

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