Keratoconus is characterized by central or paracentral corneal bulging and progressive thinning. It may present and progress during adolescence and is often familial. Keratoconus is more common in Down syndrome, atopic diseases, Leber congenital amaurosis, and chronic eye rubbing. Iron lines (Fleischer rings), stress lines (Vogt striae), and apical scarring are often noted. Tears in Descemet membrane can occur and cause acute corneal edema (hydrops).
Figure 21-2 Microcornea, right eye.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.