The Telltale Indentation

A 53-year-old man’s fall reveals a peculiar eye sign and progressive Vision Loss. Explore the diagnosis behind dome-shaped eyes and eyelid deflection.

Keratoconus


A 53-year-old man who had been admitted to the hospital after a fall was noted to have an abnormal indentation of the lower eyelids. He had a history of corneal transplantation in both eyes. He had recently experienced progressive visual impairment, which had led to his fall. Ophthalmologic examination was notable for a deflection of the lower eyelids when he was looking down, owing to dome-shaped eyes, and decreased visual acuity. What is the most likely diagnosis?

What is the most likely diagnosis?

Astigmatism
Corneal ulcer
Keratoconus
Keratoglobus
Pellucid marginal degeneration

Corneal Ectasia, Corneal Transplantation, Keratoconus, Munson’s Sign, Visual Impairment

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