Keratoglobus: a close entity to megalophthalmos
© The Author(s) 2016
Received: 17 March 2016
Accepted: 9 May 2016
Published: 17 May 2016
Keratoglobus closely resembles buphthalmos and anterior megalophthalmos.
A 45-year-old man presented with gradually progressive, painless, diminution of vision in both eyes since childhood. On examination, visual acuity of right (RE) and left eye (LE) was 20/60 and 2/20 respectively. Clinical pictures of the patient are shown in panel A, B, C, D. Keratometry values were 46.47/47.94 D at 42/132° in RE and 46.90/47.23 D at 174/84° in LE, signifying steep, ectatic cornea. Axial lengths, anterior chamber depth and corneal thickness in RE/LE was 23.53/27.12 mm, 5.18/4.48 mm and 413/420 μm respectively. Iridodonesis was noted in left eye. Retinal evaluation of LE revealed retinal detachment (RD) with posterior staphyloma due to high myopia, hereas RE was within normal limits. Intraocular pressure was normal in both eyes. Final diagnosis was keratoglobus with LE myopic RD. The patient improved to 20/30 in right eye with no improvement in LE with scleral contact lens.
Keratoglobus, Megalophthalmos and Buphthalmos are exceedingly close entities and it is very essential to make correct diagnosis, as management options differ significantly for all three diseases.
Enumeration of differentiating points between keratoglobus, anterior megalophthalmos and buphthalmos
No definite pattern
Age of presentation
First year of life
Frequent change of glasses
Variable and nonspecific
Intra ocular pressure (IOP)
>13mm; symmetric with increased WTW diameter
Variable, depends upon severity of glaucoma
Increased axial length
Increased axial length
Iridodonesis; iris stromal hypoplasia
Normal with high insertion
Normal with increased propensity for glaucoma
Cup:disc ratio increased
Refractive error correction and keratoplasty in advanced cases
Refractive errors correction
Control of IOP (medically/surgically)
Keratoglobus, Megalophthalmos and Buphthalmos are exceedingly close entities and it is very essential to make a correct diagnosis, as management options differ significantly for all three diseases (Table 1).
Both the authors, mentioned for this manuscript contributed considerably in clinical evaluation of the patient and manuscript writing. Both authors read and approved the final manuscript.
The authors acknowledge the experts from the Cornea and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi for their guidance.
The authors declare that they have no competing interests.
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- Dua HS, Azuara-Blanco A, Pillai CT (1999) Cataract extraction and intraocular lens implantation in anterior megalophthalmos. J Cataract Refract Surg 25:716–719View ArticleGoogle Scholar
- Lockington D, Ramaesh K (2015) Use of a novel lamellar keratoplasty with pleat technique to address the abnormal white-to-white diameter in keratoglobus. Cornea 34:239–242View ArticleGoogle Scholar
- Smolek MK, Klyce SD (2000) Is keratoconus a true ectasia? An evaluation of corneal surface area. Arch Ophthalmol 118:1179–1186View ArticleGoogle Scholar
- Tsai C-K, Lai I-C, Kuo H-K, Teng M-C, Fang P-C (2005) Anterior megalophthalmos. Med J 28:191–195Google Scholar