Transient rigid lens-induced striae in keratoconus

Area of Science:

• Ophthalmology
• Corneal Diseases
• Optometry

Background:

• Keratoconus is a progressive thinning of the cornea, leading to irregular astigmatism.
• Early diagnosis of keratoconus is crucial for effective management and preventing vision loss.
• Subtle or questionable signs of keratoconus pose diagnostic challenges for clinicians.

Purpose of the Study:

• To investigate the diagnostic utility of spontaneous striae observed after rigid gas permeable (RGP) contact lens wear in patients with suspected early keratoconus.
• To assess the role of RGP lenses in enhancing the visibility of corneal striae for differential diagnosis.

Main Methods:

• Observation of spontaneous striae development in the posterior cornea of six patients suspected of early keratoconus.
• Application and removal of rigid gas permeable contact lenses to assess striae visibility and persistence.
• Clinical assessment for definitive biomicroscopic signs of keratoconus.

Main Results:

• Spontaneous striae were observed and enhanced in visibility after RGP lens placement in patients with suspected early keratoconus.
• These corneal striae subsided upon removal of the RGP lens.
• Similar striae were not observed in patients without clinical signs suggestive of early keratoconus.

Conclusions:

• RGP lens wear can induce transient striae, serving as a valuable diagnostic sign for early keratoconus.
• This observation aids in the differential diagnosis of irregular astigmatism, particularly when definitive keratoconus signs are subtle or absent.
• Corneal striae observation during RGP lens fitting can confirm keratoconus diagnosis in ambiguous cases.