title: Keratoglobus: An experience at a tertiary eye care center in India.
abstract: BACKGROUND
  This study was carried out as a part of an internal audit and is the largest series of patients having keratoglobus, published in the literature. Poor visual acuity of the patients indicates the blinding nature of the disease.
  
  
  OBJECTIVE
  We report our experience with patients having keratoglobus at a tertiary eye care center in India.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  We analyzed adults and pediatric patients (<16 years) with keratoglobus, seen during 2008-2012. The age, gender, consanguinity, presenting ocular signs, ocular and systemic associations, visual acuity, corneal topography, and surgeries were documented.
  
  
  RESULTS
  Forty-eight patients (mean age 22 ± 15 years, 31 males) having keratoglobus were analyzed. 21 patients (42 eyes) were <16 years. Twelve eyes (16 events) had positive history of trauma. The presenting clinical signs were corneal scars/scars of tear repair (15 eyes), hydrops, healed and acute (14 eyes) and corneal or globe rupture (9 eyes). Best-corrected visual acuity was >20/40 in 6/42 (14.3%) pediatric eyes and 15/53 (28.30%) adults. Visual acuity ranging from counting of fingers to no light perception was noted in 20/53 (37.74%) adults and 21/42 (50%) pediatric patients; 13/20 (65%) with blue sclera and 8/22 eyes (36.37%) without blue sclera. Vernal keratoconjunctivitis was present in one pediatric patient. Choroidal osteoma, retinitis pigmentosa, and retinal detachment were present in adults. Surgeries performed were corneal tear repair (5 eyes), tissue adhesive application (2 eyes), descematopexy (4 eyes) and penetrating keratoplasty (PK - 8 eyes: Three had post-PK glaucoma, graft failure-one eye, 4 patients wore scleral lens - prosthetic replacement of the ocular surface ecosystem).
  
  
  CONCLUSIONS
  About 50% of pediatric eyes (65% having blue sclera) had no functional vision. Trivial trauma was responsible for corneal rupture indicating need for protective glasses. About 50% patients had post-PK glaucoma though grafts were clear.
authors.affiliation: Cornea Services, L V Prasad Eye Institute, Kallam Anji Reddy Camus, Hyderabad, Telangana, India.
authors.forename: Varsha M
authors.initials: VM
authors.lastname: Rathi
authors.forename: Somasheila I
authors.initials: SI
authors.lastname: Murthy
authors.forename: Bhupesh
authors.initials: B
authors.lastname: Bagga
authors.forename: Mukesh
authors.initials: M
authors.lastname: Taneja
authors.forename: Sunita
authors.initials: S
authors.lastname: Chaurasia
authors.forename: Virender S
authors.initials: VS
authors.lastname: Sangwan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000002:abnormalities* / Q000601:surgery; D003316:Corneal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D019781:Corneal Topography; D016039:Corneal Transplantation; D005139:Eyeglasses; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult