Keratoglobus (A Photo Essay)
Title: Keratoglobus (A Photo Essay)
Author: Austin S. Nakatsuka, MD; Amy Lin, MD; Mohamed Soliman, MD
Date: Images were taken with an iPhone camera at the University of Texas Medical Branch Hospital, Galveston, TX 12/28/2018
Keywords/Main Subjects: Keratoconus, keratoglobus, cornea, corneal ectasia, trauma, ruptured globe, corneal perforation
A) Parallel view of the diffusely ectatic cornea, left eye
B and C) Pigmented trabecular meshwork can be directly viewed due the severe steepening of the cornea at the limbus (arrows), left eye
D and E) Traumatic full-thickness corneal perforation at the limbus with iris prolapse, right eye
Brief Description: An African-American male presented to the Emergency Department with a traumatic ruptured globe of the right eye following blunt force injury with a metallic popcorn can. The patient was found to have a 4 clock hour corneal perforation at the limbus (Images D and E). In the operating room, the patient was noted to have diffusely ectatic corneas bilaterally, with severe steepening from limbus to limbus (Image A). Repair of the corneal perforation was done with multiple buried nylon sutures.
Keratoglobus is a bilateral ectasia that is generally congenital and characterized by diffuse thinning, worse in the periphery adjacent to the limbus. It is associated with systemic collagen disorders such as Ehlers-Danlos, osteogenesis imperfecta, and Marfan’s syndrome. Patients with keratoglobus are prone to corneal perforations due to their extreme corneal thinning.1
- Wallang BS, Das S. Keratoglobus. Eye (Lond). 27(9):1004–1012 (2013).
Faculty approval by: Amy Lin, MD
Disclosure (Financial or other): None