Keratoglobus

Keratoglobus (from Greek: kerato- horn, cornea; and Latin: globus round) is a degenerative non-inflammatory disorder of the eye in which structural changes within the cornea cause it to become extremely thin and change to a more globular shape than its normal gradual curve. It causes corneal thinning, primarily at the margins, resulting in a spherical, slightly enlarged eye.

It is sometimes equated with "megalocornea".^[1]

Pathophysiology

Keratoglobus is a little-understood disease with an uncertain cause, and its progression following diagnosis is unpredictable. If afflicting both eyes, the deterioration in vision can affect the patient's ability to drive a car or read normal print. It does not however lead to blindness.

Treatment

Treatment includes the use of protective eye glasses.^[2] A number of surgical options are also available.^[2]

Further progression of the disease usually leads to a need for corneal transplantation because of extreme thinning of the cornea. Primarily, large size penetrating keratoplasty has been advocated. Recent additions of techniques specifically for keratoglobus include the "tuck procedure",^[3] whereby a 12 mm corneo-scleral donor graft is taken and trimmed at its outer edges. A host pocket is formed at the limbal margin and the donor tissue is "tucked" into the host pocket.

Prognosis

Keratoglobus continues to be a somewhat mysterious disease, but it can be successfully managed with a variety of clinical and surgical techniques. The patient is at risk for globe perforation because the thinned out cornea is extremely weak.

Epidemiology

It is a much rarer condition than keratoconus, which is the most common dystrophy of the cornea.^[4] Similar to keratoconus it is typically diagnosed in the patient's adolescent years and attains its most severe state in the twenties and thirties.

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