Temporal keratoconus in a pediatric patient

• Published in: American journal of ophthalmology case reports Vol. 32; p. 101900
• Main Authors: Zhang, Lyvia J, Traish, Aisha S, Dohlman, Thomas H
• Format: Report
• Language: English
• Published: 01.12.2023
• ISSN: 2451-9936
• DOI: 10.1016/j.ajoc.2023.101900

PurposeTo report a pediatric patient with bilateral temporal keratoconus.ObservationsA 14-year-old male presented with a two-year history of progressively worsening visual acuity in both eyes and suspicion for undiagnosed amblyopia in the right eye. Retinoscopy revealed a scissoring reflex in both eyes and corneal topography demonstrated high keratometry values (Kmax 57.9 D and 46.1 D in the right and left eyes, respectively), with relative temporal steepening approximately coinciding with the thinnest pachymetry in both eyes. Corneal cross-linking was recommended.Conclusions and importanceKeratoconus can present as a temporal variant with relative temporal steepening and thinning. It is important to maintain a high index of suspicion for keratoconus in pediatric patients with sub-normal visual acuities. Prompt assessment and diagnosis may prevent progression of keratoconus and development of amblyopia.