[Decreased visual acuity in young patients; Javal's ophthalmometer is still contributing]

The purpose of this study was to recall the advantages of the Javal ophthalmometer in screening keratoconus.

In three young patients with progressive visual loss, optic neuropathy was strongly suspected by their ophthalmologist despite a strictly normal neuro-ophthalmology record. The patients underwent an ophthalmic clinical examination at the Bordeaux University Hospital, which guided the paraclinical examination with corneal videotopography (Orbscan II(®), Bausch and Lomb) and the biomechanical properties of the cornea with the ocular response analyzer (ORA(®), Reichert).

Visual acuity improved in all patients on the pinhole visual acuity test. The videotopography concluded in keratoconus in all three patients. The biomechanical parameters were abnormal. The patients were equipped successfully with hard contact lenses.

Despite the latest technologies including videotopography and ORA(®), examination of the cornea with the Javal ophthalmometer remains a landmark of the eye examination and can assist in screening some keratoconus conditions and avoiding diagnostic uncertainties as well as inappropriate and expensive paraclinical examinations.