Bilateral recurrent self-induced keratoconus.

Area of Science:

• Ophthalmology
• Corneal Diseases
• Ocular Surface Disease

Background:

• Keratoconus is a progressive thinning of the cornea, leading to irregular astigmatism.
• Corneal transplants are a treatment for advanced keratoconus.
• Self-induced eye trauma is a potential risk factor for corneal conditions.

Observation:

• A patient with a history of self-induced keratoconus due to compulsive eye rubbing developed bilateral recurrent keratoconus post-corneal transplant.
• Slit-lamp examination revealed corneal stromal thinning and scarring in the right eye.
• Temporal corneal hydrops were observed in the left eye.

Findings:

• Videokeratography confirmed corneal steepening and irregular astigmatism in the right corneal transplant, indicative of recurrent keratoconus.
• The findings in both eyes were consistent with keratoconus affecting the corneal transplants.
• The patient's history of compulsive eye rubbing correlated with the observed corneal changes.

Implications:

• Chronic mechanical trauma from eye rubbing may be a contributing factor to the development and recurrence of keratoconus.
• Understanding the role of mechanical stress is crucial for managing and preventing keratoconus progression.
• This case underscores the importance of addressing compulsive eye-related behaviors in patients with or at risk for keratoconus.