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The Youngest Patient with Bilateral Keratoconus Secondary to Chronic Persistent Eye Rubbing
Alime Gunes1, Levent Tok1, Özlem Tok1
1a Department of Ophthalmology , Süleyman Demirel University , Isparta , Turkey.
Insights
Chronic eye rubbing in a young child led to bilateral keratoconus, a condition causing vision loss. This case highlights the importance of considering keratoconus in children with persistent eye itching.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Keratoconus is a progressive eye condition characterized by thinning and bulging of the cornea.
- Ocular itching is a common symptom that can lead to eye rubbing.
Observation:
- A four-year-old girl presented with severe ocular itching and low vision.
- Clinical examination revealed bilateral papillary reactions and corneal topography consistent with keratoconus.
- The patient's history indicated chronic, persistent eye rubbing.
Findings:
- The case represents the youngest patient reported with bilateral keratoconus secondary to chronic eye rubbing.
- Eye rubbing, potentially a form of trauma, can contribute to keratoconus development even in early childhood.
Implications:
- Ophthalmologists should consider keratoconus in the differential diagnosis of children presenting with intractable ocular itching.
- Early identification and management of eye rubbing behaviors in children may help prevent or slow the progression of keratoconus.
Abstract:
We present the case of a four-year-old girl with bilateral keratoconus secondary to chronic persistent eye rubbing. She was referred to our clinic with intractable ocular itching and low vision. According to her family, she was generally rubbing her eyes. On slit-lamp biomicroscopic examination, bilateral papillary reactions were seen on the upper tarsal conjunctiva. Clinical examination and corneal topography were compatible with keratoconus. The patient's visual acuity was not evaluated because of cooperation difficulties. Systemic examination was normal. In fact, trauma may be the common underlying factor in eye rubbing and may cause development of keratoconus, even in the early years. To the best of our knowledge, this is the youngest patient with bilateral keratoconus secondary to chronic persistent eye rubbing in the literature. Keratoconus should be kept in mind in patients with severe ocular itching, even in small children.
