Biala Abhinav, Kazi Mohd, Chaurasia Sunita
Refractive Surgery Services, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Contact Lens Services, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2020 Apr;68(4):658-659. doi: 10.4103/ijo.IJO_1227_19.
An 18-year-old male presented with complaints of gradually decreasing vision in both eyes for 6 years. He was a diagnosed with juvenile scleroderma at the age of 11 years by a pediatric rheumatologist. Clinical slit lamp examination showed features of ectasia, thinning, Vogt's striae, and apical scarring in both eyes. Bulbar and tarsal conjunctiva was quiet and normal. Corneal tomography revealed mean keratometry 65.8 and 65.4 diopters, thinnest pachymetry of 351 and 224 microns in the right and left eye, respectively. There was no history of itching and eye rubbing in the past. Patients of juvenile scleroderma may have associated keratoconus. The management of advanced keratoconus presents challenges related to handling and insertion of contact lenses in this condition. Keratoplasty is an option in those patients when contact lenses are not acceptable.
一名18岁男性因双眼视力逐渐下降6年前来就诊。他11岁时被儿科风湿病学家诊断为青少年硬皮病。临床裂隙灯检查显示双眼有扩张、变薄、Vogt条纹和顶端瘢痕形成的特征。球结膜和睑结膜平静且正常。角膜地形图显示右眼和左眼的平均角膜曲率分别为65.8和65.4屈光度，最薄角膜厚度分别为351和224微米。既往无瘙痒和揉眼史。青少年硬皮病患者可能合并圆锥角膜。在这种情况下，晚期圆锥角膜的治疗在隐形眼镜的处理和佩戴方面存在挑战。对于那些无法接受隐形眼镜的患者，角膜移植是一种选择。
