Why wasn’t keratoconus easily diagnosed in earlier decades?
JUN 05, 2020
Question:
I was diagnosed with keratoconus in 2005 and it was determined that it occurred while I was on active duty in the military (1974-1988), but my claim was denied because none of my exams document it. I discovered the reason is that the technology was not available then. Can you tell me when the technology became affordable for ophthalmology practices? Also, what exposure (especially military) could have caused it? Any help you can provide in pointing me to peer-reviewed studies and other information is greatly appreciated.
Answer:
As to technology, instruments for earlier detection of keratoconus were developed in the 1980s. These were corneal topographers and tomographers. Before then, it was more difficult to make a definitive diagnosis of keratoconus until the disease had progressed to the point of visually significant irregular astigmatism or changes seen on eye examination.
There are several causes of keratoconus, with connective tissue disorders and eye rubbing the two most likely contributing factors. I’m not aware of anything inherent to military service that would increase the risk of developing keratoconus. A PubMed search on “keratoconus and etiology” will return a wealth of peer-reviewed scientific papers.