A case report and review of band keratopathy

A five-year-old male presented with band keratopathy as the first sign of proximal renal tubular acidosis. The band keratopathy was progressive with decreasing visual acuity. Treatment with EDTA was repeated in each eye with only minimal improvement. The pediatric renal service found the serum calcium to be no higher than 10.5 mg% and phosphorus no higher than 6.8 mg%. The calcium-phosphorus product was in the range of 60-65. Band keratopathy can be visually incapacitating and has multiple etiologies. Factors other than elevated calcium concentrations must predispose to development of this disorder. Certain of these factors and a review of band keratopathy are presented in the following article.