Interesting Retinal Cases
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Oxidative stress drives AMD
β’ Key triggers: UV exposure, smoking, and poor diet.
β’ Guide patients on prevention: Advise quitting smoking, consistent UV protection, and encouraging a diet rich in leafy greens for long-term eye health.
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β’ Definition
Progressive corneal ectasia β stromal thinning + anterior protrusion β irregular astigmatism
β’ Epidemiology
β onset: teens to early adulthood
β often bilateral, asymmetric
β’ Pathophysiology
β structural weakening of corneal collagen
β non-inflammatory
β’ Risk factors
β eye rubbing
β atopy (allergies, eczema, asthma)
β family history
β connective tissue disorders
β’ Symptoms
β progressive blur
β increasing astigmatism
β frequent Rx changes
β ghosting, halos, monocular diplopia
β’ Refraction clues
β increasing cyl
β irregular astigmatism
β reduced BCVA with glasses
β scissors reflex on retinoscopy
β’ Slit lamp signs
β Vogtβs striae (fine vertical stress lines)
β Fleischer ring (iron deposition)
β corneal thinning, conical protrusion
β Β± apical scarring (advanced)
β’ Topography / Tomography
β inferior steepening
β asymmetric bow-tie
β posterior elevation (early detection)
β’ Complication
β acute corneal hydrops (Descemet break β stromal edema)
β’ Management
Early: glasses / soft toric CL
Moderate: RGP / scleral lenses
Progression: corneal cross-linking (CXL)
Advanced: INTACS or corneal transplant
β’ Key clinical pearl
Young patient with changing astigmatism + β BCVA β think keratoconus and get topography early
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Whatβs hiding behind this cataract? Letβs find out.
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