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Keratoconus: Diagnosis and Staging.

Michael W Belin1, Hyun Soo Jang1, Mark Borgstrom2

  • 1Department of Ophthalmology and Vision Science, University of Arizona, Tucson, AZ; and.

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|June 11, 2021
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Summary

Early detection of subclinical ectatic disease is crucial. Modern tomographic imaging and the Belin ABCD system enable earlier diagnosis and monitoring of keratoconus, preventing vision loss.

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Area of Science:

  • Ophthalmology
  • Corneal Imaging
  • Refractive Surgery

Background:

  • Traditional methods for diagnosing ectatic diseases rely on late-stage anterior corneal changes.
  • These late changes are often linked to irreversible visual impairment.
  • The need for early detection of subclinical ectatic conditions is paramount, especially with advancements in refractive surgery and corneal cross-linking.

Purpose of the Study:

  • To review modern diagnostic methods for early or subclinical ectatic corneal disease.
  • To highlight the role of tomographic imaging in assessing posterior corneal surface and pachymetric distribution.
  • To discuss screening tools and the distinction between ectasia screening and keratoconus diagnosis.

Main Methods:

  • Review of current literature on corneal tomography and ectatic disease assessment.
  • Discussion of screening tools integrated into common tomographic imaging devices.
  • Analysis of the Belin ABCD staging and classification system and the ABCD Progression Display.

Main Results:

  • Tomographic imaging provides crucial posterior corneal and pachymetric data, hallmarks of ectatic disease.
  • Modern screening tools facilitate early diagnosis of subclinical keratoconus and patient selection for refractive surgery.
  • The Belin ABCD system offers a novel approach to grading and monitoring disease progression.

Conclusions:

  • Advances in corneal imaging have revolutionized the detection of early ectatic disorders.
  • The Belin ABCD system represents a significant step forward in managing keratoconus, enabling earlier intervention.
  • Proactive management through early detection and monitoring is key to preventing vision loss in keratoconus patients.