Background: Ophthalmic evaluation of patients with keratoconus (KC) often reveals highly myopic and irregular astigmatic refractive corrections. Irregular corneal astigmatism and central corneal scarring in patients with KC often result in a loss of best-corrected spectacle acuity. Rigid gaspermeable contact lenses generally optimize visual acuities for patients with KC.
Case reports: Two cases are discussed of patients who manifested clinically diagnosed KC but unusually good unaided Snellen visual acuities (20/25+ or better) in both eyes.
Conclusion: Good unaided visual acuities are not necessarily inconsistent with the diagnosis of KC.
Do you keep telling yourself it's time to get in shape? Are you adding workouts to your list of New Year's resolutions? If you think you can't balance fitness with a busy schedule, think again. Here are the stories of some optometrists who have done just that (along with a couple of hard-core ODs who've taken fitness to a higher level).
Bringing a new optometrist into a practice, even if only on an employer-employee basis, is a complicated process that should not be taken lightly by hirer or hiree. This article explores the many aspects of the process and the relationship that must be understood and worked out in advance.
Background: Posterior keratoconus has only a few scattered case reports in the literature. Posterior keratoconus is characterized by a posterior stroma thinning and a depression of the posterior corneal surface. The effect on acuity is variable and may be related to other ocular and systemic conditions.
Case report: An African-American woman came to us with posterior concavity (corneal thinning), with stromal scarring in both eyes and an epithelial iron ring present in the left eye. The endothelia layer appeared intact in both eyes. Corneal topography of the right eye demonstrated a central flattened zone with peripheral steepening, while the left eye an inferior nasal steepened zone was present. The patient was also diagnosed with myopic degeneration (O.D. > O.S.) as well as cataracts.
Conclusions: Posterior keratoconus generally has a minimal effect on visual performance and requires no specific treatment. In cases in which visual defect is severe and is attributable to the posterior keratoconus--and not other ocular conditions, such as cataracts--penetrating keratoplasty should be considered.
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