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Ophthalmology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
This disorder results in a central or paracentral thinning of the cornea, leading to poor visual acuity due to irregular and/or high astigmatism as the cornea bulges outward in a cone shape. Using direct ophthalmoscopy and a dilated pupil an oil droplet sign is seen. Other signs include scissoring of the light reflex on retinoscopy, slit lamp signs (Fleischer’s ring, which is a brown deposition of iron in the epithelium at the base of the cone; Vogt’s striae, which are small, thin, parallel striations in Descemet’s membrane in the area of the cone, which with gentle pressure on the globe will momentarily disappear; prominent corneal nerves; endothelial guttata; and posterior shagreen). Rizutti’s sign is that of a conical reflection nasally as a penlight is shone across the cornea from the temporal side. This tends to be a late sign of keratoconus, as is Munson’s sign – a bulging of the lower eyelid anteriorly in downgaze, as a result of the cone pushing on the eyelid.
Pediatric Keratoconus in A Tertiary Eye Center in Alexandria: A Cross-sectional Study
Published in Ophthalmic Epidemiology, 2022
Shahira Mahmoud, Ahmed El-Massry, Mohamed Bahgat Goweida, Islam Ahmed
A complete patient history was taken, including details about the initial complaint, family history of keratoconus, presence of itching, medical history, and any previous interventions. All patients also underwent a thorough ophthalmic examination using slit-lamp biomicroscopy to detect signs of keratoconus (e.g., Vogt's striae, Fleischer ring, prominent corneal nerves, hydrops, Munson’s sign, or corneal scar) and signs of VKC and a dilated fundus examination. Manifest refraction data were obtained when possible. A decimal chart was used to measure the best spectacle corrected visual acuity (BSCVA) then the decimal visual acuity was converted to logMAR.
Optometric practices and attitudes in keratoconus patient management in Latin America
Published in Clinical and Experimental Optometry, 2023
Sabrina Braga Vieira, Doris Rivadeneira-Bueno, Sara Ortiz-Toquero, Raul Martin
Keratoconus disease shows different ocular symptoms and signs, such as: significant loss of visual acuity that cannot be compensated with spectacles; increasing against-the-rule astigmatism; appearance of ‘scissor’ shadows while performing retinoscopy,; or presence of biomicroscopy findings (Fleischer’s ring, Vogt’s striae, corneal scarring or Munson’s sign).2 Corneal topography and tomography (Scheimpflug or optical coherence tomography) are essential for formulating a definitive diagnosis.7
The association of keratoconus with blepharitis
Published in Clinical and Experimental Optometry, 2018
Dina Mostovoy, Shlomo Vinker, Michael Mimouni, Yakov Goldich, Shmuel Levartovsky, Igor Kaiserman
The diagnosis of keratoconus was reconfirmed based on corneal topography (GALILEI Dual Scheimpflug Analyzer, Ziemer, Port, Switzerland). All keratoconus subjects manifested one or more of the following clinical signs: posterior stress lines (Vogt striae), Fleischer ring, external sign (Munson sign) together with a topography positive for keratoconus (central corneal power superior to 48.7 D, and an inferior superior asymmetry above 1.4).1995 Subjects with any previous ocular surgery were excluded.