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Ocular allergy and keratoconus.

Sharma N, Rao K, Maharana PK, Vajpayee RB - Indian J Ophthalmol (2013)

Bottom Line: These cases may require early keratoplasty and are at an increased risk of having acute corneal hydrops.However, post-operative epithelial breakdown may be a problem in these cases.Control of allergy and eye rubbing is the best measure to prevent corneal ectasias in cases of ocular allergy.

View Article: PubMed Central - PubMed

Affiliation: Department of Cornea and Refractive Surgery, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Keratoconus is the most common corneal ectatic disorder, the cause of which is largely unknown. Many factors have been implicated, and the ocular allergy is being one of them. The commonly proposed pathogenesis includes the release of inflammatory mediators due to eye rubbing which may alter the corneal collagen and lead to corneal ectasias. The onset of keratoconus is often early in cases associated with allergy and routine corneal topography may detect subtle forms of keratoconus. These cases may require early keratoplasty and are at an increased risk of having acute corneal hydrops. Surgical outcomes are similar to primary keratoconus cases. However, post-operative epithelial breakdown may be a problem in these cases. Control of allergy and eye rubbing is the best measure to prevent corneal ectasias in cases of ocular allergy.

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Related in: MedlinePlus

Same case as in Figure 1with keratoconus
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Figure 2: Same case as in Figure 1with keratoconus

Mentions: KC accounts for almost 90% of the lamellar keratoplasties and 5-10% of PKP are done at our center. VKC is the commonest type of association we find in our cases [Figs. 1 and 2]. These cases usually present early (in fact we have seen advanced KC cases at the age of 8 years) and show rapid progression. Patients with concomitant VKC may require early keratoplasty in cases of KC. Moreover, history of eye rubbing, VKC, and atopy increase the risk for developing acute corneal hydrops.[12] Post-operative course is also quite challenging in these cases. Chances of postoperative prolonged inflammation, epithelial breakdown and rapid healing with early loosening of sutures are commonly observed in these cases. Eye rubbing is the leading factor for early onset and rapid progression, hence all the cases of atopy or VKC must be advised to avoid eye rubbing. Prior to the surgery it must be ensured that the inflammation is controlled.


Ocular allergy and keratoconus.

Sharma N, Rao K, Maharana PK, Vajpayee RB - Indian J Ophthalmol (2013)

Same case as in Figure 1with keratoconus
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3775074&req=5

Figure 2: Same case as in Figure 1with keratoconus
Mentions: KC accounts for almost 90% of the lamellar keratoplasties and 5-10% of PKP are done at our center. VKC is the commonest type of association we find in our cases [Figs. 1 and 2]. These cases usually present early (in fact we have seen advanced KC cases at the age of 8 years) and show rapid progression. Patients with concomitant VKC may require early keratoplasty in cases of KC. Moreover, history of eye rubbing, VKC, and atopy increase the risk for developing acute corneal hydrops.[12] Post-operative course is also quite challenging in these cases. Chances of postoperative prolonged inflammation, epithelial breakdown and rapid healing with early loosening of sutures are commonly observed in these cases. Eye rubbing is the leading factor for early onset and rapid progression, hence all the cases of atopy or VKC must be advised to avoid eye rubbing. Prior to the surgery it must be ensured that the inflammation is controlled.

Bottom Line: These cases may require early keratoplasty and are at an increased risk of having acute corneal hydrops.However, post-operative epithelial breakdown may be a problem in these cases.Control of allergy and eye rubbing is the best measure to prevent corneal ectasias in cases of ocular allergy.

View Article: PubMed Central - PubMed

Affiliation: Department of Cornea and Refractive Surgery, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Keratoconus is the most common corneal ectatic disorder, the cause of which is largely unknown. Many factors have been implicated, and the ocular allergy is being one of them. The commonly proposed pathogenesis includes the release of inflammatory mediators due to eye rubbing which may alter the corneal collagen and lead to corneal ectasias. The onset of keratoconus is often early in cases associated with allergy and routine corneal topography may detect subtle forms of keratoconus. These cases may require early keratoplasty and are at an increased risk of having acute corneal hydrops. Surgical outcomes are similar to primary keratoconus cases. However, post-operative epithelial breakdown may be a problem in these cases. Control of allergy and eye rubbing is the best measure to prevent corneal ectasias in cases of ocular allergy.

Show MeSH
Related in: MedlinePlus