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圆锥角膜:家庭医生的诊断与管理

Keratoconus: Diagnosis and Management by Family Physicians.

作者信息

Aranda A C, Quitério Sandra S, Junqueira Bárbara

机构信息

Family Medicine, Unidade de Saúde Familiar (USF) São Domingos, Unidade Local de Saúde (ULS) da Lezíria, Santarém, PRT.

Family Medicine, Unidade de Saúde Familiar (USF) Cartaxo Terra Viva, Unidade Local de Saúde (ULS) da Lezíria, Cartaxo, PRT.

出版信息

Cureus. 2025 Jun 24;17(6):e86668. doi: 10.7759/cureus.86668. eCollection 2025 Jun.

Abstract

Keratoconus is a chronic progressive disease that affects the cornea. Given the nonspecificity of the initial symptoms, it is often confused with common refractive errors (myopia and irregular astigmatism). This is a case of a 29-year-old male patient with a progressive decrease in visual acuity in his right eye, associated with ocular pruritus and frequent eye rubbing. Clinical examination revealed signs suggestive of keratoconus, leading to a timely referral to ophthalmology. Even so, the patient had to undergo a corneal transplant. Despite rapid recognition and referral by a family physician (FP), the impact on quality of life was significant, requiring time off work and support for daily activities. The case illustrates the importance of thorough physical examination and clinical suspicion in Primary Health Care for early diagnosis. It highlights the role of FPs in preventing the progression of the disease and collaborative management with ophthalmology to improve the prognosis and quality of life of patients.

摘要

圆锥角膜是一种影响角膜的慢性进行性疾病。鉴于初始症状的非特异性,它常与常见的屈光不正(近视和不规则散光)相混淆。这是一例29岁男性患者,其右眼视力逐渐下降,伴有眼部瘙痒和频繁揉眼。临床检查发现了提示圆锥角膜的体征,从而及时转诊至眼科。即便如此,该患者仍不得不接受角膜移植。尽管家庭医生(FP)迅速识别并进行了转诊,但对生活质量的影响仍然很大,需要请假并在日常活动中得到帮助。该病例说明了在初级卫生保健中进行全面体格检查和临床怀疑对于早期诊断的重要性。它凸显了家庭医生在预防疾病进展以及与眼科协作管理以改善患者预后和生活质量方面的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ae/12288942/6fb6095a590d/cureus-0017-00000086668-i01.jpg

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