Clinical Report: Rapidly Progressive Keratoconus in a Stable Scleral Lens Fit
Overview
Expand on the implications of successful scleral lens fitting despite rapid keratoconus progression.
Background
Keratoconus is a progressive corneal disease characterized by corneal ectasia and steepening, which can lead to visual impairment. Understanding the progression of keratoconus is crucial for timely interventions, such as corneal crosslinking. This case highlights the challenges of managing keratoconus in older patients, where rapid progression can occur unexpectedly.
Data Highlights
| Eye | Keratometry Values (D) | Best-Corrected Acuity |
|---|---|---|
| Right | Not obtainable due to scarring | 20/100 |
| Left | 47.00/56.75 to 52.25/63.00 | 20/30 |
Key Findings
- A 35-year-old female patient with a history of keratoconus experienced rapid progression of the disease.
- Keratometry values increased significantly in the left eye over 6 months, indicating worsening steepening.
- Despite the progression, the sagittal depth of the cornea remained stable during the same period.
- The patient reported improved comfort with the new InSight Scleral lenses compared to previous lenses.
- Corneal crosslinking was discussed but not pursued due to financial constraints.
Clinical Implications
Regular follow-up is essential for patients with keratoconus, especially in older individuals where progression may be unexpected. Clinicians should consider the stability of scleral lens fits even in the presence of rapid corneal changes, and discuss financial options for interventions like corneal crosslinking.
Conclusion
This case underscores the importance of monitoring keratoconus progression and the potential for successful management with scleral lenses, even in rapidly changing conditions.
References
- Kemp, A., Contact Lens Spectrum, 2023 -- Rapidly Progressive Keratoconus in a Stable Scleral Lens Fit
- Johns, L.K., Contact Lens Spectrum, 2011 -- Fitting Scleral Lenses for Ocular Surface Disease
- Nau, H., Contact Lens Spectrum, 2018 -- THE SCLERAL LENS VAULT
- Loftin, M.M., Contact Lens Spectrum, 2006 -- Fitting Scleral Lenses
- AAO, PubMed, 2023 -- Corneal Ectasia Preferred Practice Pattern®
- Contact Lens Spectrum — ONLINE PHOTO DIAGNOSIS
- Randomized, Controlled Study to Evaluate the Safety and Efficacy of Oxygen-Enriched Epithelium-On Corneal Cross-Linking for the Treatment of Keratoconus
- Visual outcomes of scleral lenses in different stages and cone locations of keratoconus: A retrospective observational study
- Corneal Ectasia Preferred Practice Pattern® - PubMed
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