Acute keratoconus: clinical cases

Indrė Rašinskaitė1 , Saulius Galgauskas1,2

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania

2Vilnius University, Faculty of Medicine, Institue of Clinical Medicine, Clinic of Era, Nose, Throat and Eye Diseases, Center of Eye Diseases, Vilnius, Lithuania

Abstract

Background. Keratoconus is chronic ectatic corneal disease. The progressive thinning of corneal stroma causes corneal cone shape and impaired vision. The etiology of the disease is associated with genetic, environmental factors, allergic and atopic diseases. Keratoconus usually progresses slowly firstly affecting one eye. Acute course of the disease is rare, manifested by acute swelling of the cornea.

Clinical case No.1. 21 y.o. man presented at emergency department with decreasing visual acuity of the right eye. Complaints appeared two weeks ago, during that time he used artificial tears. One week after the onset of symptoms, the patient was consulted by an ophthalmologist and diagnosed with acute right eye keratitis. Swelling of the right corneal stroma, descemetitis was observed during admission to the hospital. Topographic revealed greater corneal curvature in the lower right eye.

Clinical case No.2. 28 y.o. patient with Down syndrome was consulted due to impaired left eye visual acuity, tearing lasting five days. Ophthalmologist observed corneal edema, viral keratitis was suspected and levofloxacin drops and aciclovir tablets were prescribed. During objective examination, a strong swelling of the left corneal stroma, bulls, rupture of the Descemete’s membrane were observed. Keratoconus was diagnosed by corneal topography.

Conclusion. Acute corneal hydrops is a rare complication of keratoconus. The diagnosis of keratoconus is complicated if acute hydrops occurs as the first symptom following eye irritation, pain, photophobia. The main diagnostic method of keratoconus is topography.

Keywords: keratoconus, corneal hydrops, ectasia, corneal topography

Full article

https://doi.org/10.53453/ms.2023.2.6

Acute keratoconus: clinical cases
Indrė Rašinskaitė
1
, Saulius Galgauskas
1,2
Vilnius University, Faculty of Medicine, Vilnius, Lithuania
Vilnius University, Faculty of Medicine, Institue of Clinical Medicine, Clinic of Era, Nose, Throat and Eye
Diseases, Center of Eye Diseases, Vilnius, Lithuania
Abstract
Background



Clinical case No.1.  
 
!


Clinical case No.2. " #
 $
#%$
     #&        

Conclusion.             


Keywords'
Journal of Medical Sciences. 22 Feb, 2023 - Volume 11 | Issue 2. Electronic - ISSN: 2345-0592
Medical Sciences 2023 Vol. 11 (2), p. 51-57, https://doi.org/10.53453/ms.2023.2.6
51
Ūmus ragenos keratokonusas: klinikiniai atvejai
Indrė Rašinskaitė
1
, Saulius Galgauskas
1,2
1
Vilniaus Universitetas, Medicinos Fakultetas, Vilnius, Lietuva
2
Vilniaus universitetas, Medicinos fakultetas, Klinikinės medicinos insitutas, Ausų, nosies, gerklės ir akių ligų
klinika, Akių ligų centras, Vilnius, Lietuva
Santrauka
Įvadas. ())*)#)%+)%%
,-./)%/0%%
)  )  (  1 % )   
112,
Klinikinis atvejis Nr.1 3)-3))%,4
5,  //,,6 ) 3
1   %  * . ,)   1.
)%),)(
)%7,,))%%
Klinikinis atvejis Nr.2."#3-)3))%
),%+#))-
$,) %1.))
#,,,
,)%%
Išvados  2      % 8 % ,  
1%
6
Raktažodžiai'*%%
Journal of Medical Sciences. 22 Feb, 2023 - Volume 11 | Issue 2. Electronic - ISSN: 2345-0592
52
Įvadas
(9(:))*)3
   %  
)%.,
 ' / */ 
%/9:01)%
%+;,+(
111,
<%%%%
9: =  / /  . 
1) +   
 ,)  % +
1    
/)3
1 1(
19>:
?,(%/
)  %  
# 0)
- *) @<#  5
+(+33
) ) A< BC )
*  ,    
,) *) 9D:   (,
*/  E % )
) 9AB:5(+3%3
%% )%   ?@
%AFG9B:!
 3   7 ,7 
9C":
?CG,'
*   
)%%.AG%36%%
,   
9F:
Klinikinis atvejis Nr. 1
3)-3)
)%,4 5
 ,    / / ,
 , 6 )   3
1   %
 * . ,) 
 H   ,
,D/--
 /   / H.
)%3 
%
(,'
I< #<J<BJ;A$FJ
<JD
 !<J<CJ;J$B
<J
.,)"K)
K%/),)
     
  9 : )% %
%%)
 - /  )%7
,,))%%9
: 6   
',,
*  G
,
1 paveikslas. Dešinės akies ragenos stromos
paburkimas
Journal of Medical Sciences. 22 Feb, 2023 - Volume 11 | Issue 2. Electronic - ISSN: 2345-0592
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2 paveikslas. Ragenos topografinis žemėlapis. Dešinės akies padidėjęs ragenos išsigaubimas apatinėje dalyje
(keratokonusas).
Klinikinis atvejis Nr.2.
" 3   # 
3-)3))%
  ,% +  
#) )    
%-/
 ,   ) 6
%3 3 )   ,
,)%)
 3   
%
(,'
I< #;JD
 !;%
% 1.   %/
,)  ) )   
% )    
  )   , 
,)%    + 6%
,,))3
DAJ"FJ6)
) ) % 96 : 
))
 #  , 9> :
-/
%+,)%%
%   )% % ,,
)%%!
    
G3,E
%1)%)
7
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54
3 paveikslas. Abiejų akių priekinės optinės koherentinės tomografijos tyrimas: dešinėje akyje normali ragena;
kairėje - ragenos stromos paburkimas, bulos ir Descemeto membranos atsiskyrimas nuo stromos.
Diskusija
( 1%  %%  
*% ) ,,3  3
+3  ,%  
%  %% (  
  ,  %3
+3,%
 ( % %%  -
1+%+
/,7,I.3
  % (  
 )   , .
1;
292(6:9acute hydrops:
  , ( % 2(6
(>G9J:8
%  %  
#    -. 
% )   % -
/2(69:!
  %  ,
   2(6 %
9A:(*)
  ,) 
%%2(6 8
1 (  3 ) .)
%
7*/ 2(6 , 9>: 6
   ,  <D
)1%
1   *%  
%9AD:
  (1 ' L
1;1.1I
 % (**  ; +
,)-*
,%
7 %/  % ,
Journal of Medical Sciences. 22 Feb, 2023 - Volume 11 | Issue 2. Electronic - ISSN: 2345-0592
55
   3   
Charlouex's6 oil droplet<M
1 ;     1
*
1     %
 / I %  
  - % 1)%
 % 9DA: H <M
1 I% % 
"BG%BAG (1,3
%3 13    *7
%9B:
5(

   ( 
    *)
% ) ,  ,
*% / N)3  
   < 
/ ,% 1) 
%,/
,,.,
( ,+   1) ,
-    
77%/9F:
62(
.- 1+  
   , 
#     
  .  )
% < %3    -
7 / 9C":    
   %
%  . 1 
 , 9F: (
%)%
,,.9J:
Išvados
2     
% 8 % ,  
 1    
%
 6  

Literatūros šaltiniai
 #(K*ME#!
!(66 
?8 JF
8OBC9:'";A
 H LP  E ! 5 E 
L(6H#'
  ? 8  JJ
#OB"9:'">;D
> P (60  88P E ( ? !
( (#8 I  0%  
@$     
L' ! ( 
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@  %   
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H (   K  
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C HE6MLH86
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     J
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LO>F9A:'BB;A
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!OBF'";F
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