Literature Review : Keratoconus


  • Ardian Reza Putra Universitas Lampung
  • Putu Ristyaning Ayu Sangging Universitas Lampung
  • Rani Himayani Universitas Lampung



Keratoconus, epidemiology, aetiology and pathogenesis, clinical features, diagnostic


sexes and all ethnicities. The estimated prevalence in the general population is 54 per 100,000. Ocular signs and symptoms vary depending on the severity of the disease. The initial shape is usually unknown unless closure topography is performed. Disease progression is manifested by a loss of visual acuity that cannot be compensated for by spectacles. Edge thinning often sucks ectasia. In moderate and more severe cases, a hemosiderin arc or circular line, known as a Fleischer ring, is often seen around the base of the needle. Vogt's striae, which are fine vertical lines produced by compression of Descemet's membrane, are another characteristic. Most patients eventually develop scar tissue. Munson's sign, V-shaped deformation of the lower eyelid in the downward position; Rizzuti's sign, bright reflection of the nasal limbal region when light is directed to the temporal limbal region; and damage to Descemet's membrane leading to acute stromal edema, known as hydrops, is observed in advanced stages. . Genetic, biomechanical, and biochemical theories about the causes of keratoconus have been put forward. Treatment varies depending on the severity of the disease. This article provides a review of the definition, epidemiology, etiology, pathogenesis, clinical features, diagnosis of keratoconus.


A. Barbara, R. Barbara, A. Barua, J. Alio, and F. Bandello, “Why a dedicated section on keratoconus in the European Journal of Ophthalmology?,” European Journal of Ophthalmology. 2021: 31(4): 1513–1516

M. Mohammadpour, Z. Heidari, and H. Hashemi, “Updates on Managements for Keratoconus,” Journal of Current Ophthalmology. 2018; 30(2):110–124

Y. Li, W. Chamberlain, O. Tan, R. Brass, J. L. Weiss, and D. Huang, “Subclinical keratoconus detection by pattern analysis of corneal and epithelial thickness maps with optical coherence tomography,” J Cataract Refract Surg. 2016; 42(2): 284–295

J. Santodomingo-Rubido, G. Carracedo, A. Suzaki, C. Villa-Collar, S. J. Vincent, and J. S. Wolffsohn, “Keratoconus: An updated review,” Contact Lens and Anterior Eye, 2022; vol. 45, no. 3.

R. Oltulu, Z. Katipoğlu, A. O. Gündoğan, E. Mirza, and S. Belviranlı, “Evaluation of inflammatory biomarkers in patients with keratoconus,” Eur J Ophthalmol, 2022. vol. 32, no. 1, pp. 154–159,

Y. S. Rabinowitz, V. Galvis, A. Tello, D. Rueda, and J. D. García, “Genetics vs chronic corneal mechanical trauma in the etiology of keratoconus,” Experimental Eye Research, 2020. vol. 202.

H. Hashemi et al., “The Prevalence and Risk Factors for Keratoconus: A Systematic Review and Meta-Analysis,” 2019. [Online]. Available:

J. Vazirani and S. Basu, “Keratoconus: Current perspectives,” Clinical Ophthalmology, 2013; vol. 7. pp. 2019–2030

N. S. Gokhale, “Epidemiology of keratoconus,” in Indian Journal of Ophthalmology, Aug. 2013, vol. 61, no. 8, pp. 382–383.

H. Kandel, K. Pesudovs, and S. L. Watson, “Measurement of Quality of Life in Keratoconus,” 2019. [Online]. Available:

L. Lim and E. W. L. Lim, “Current perspectives in the management of keratoconus with contact lenses,” Eye (Basingstoke),2020; vol. 34, no. 12. Springer Nature, pp. 2175–2196,

J. L. J. Claessens, D. A. Godefrooij, G. Vink, L. E. Frank, and R. P. L. Wisse, “Nationwide epidemiological approach to identify associations between keratoconus and immune-mediated diseases,” British Journal of Ophthalmology, 2022; vol. 106, no. 10, pp. 1350–1354

S. M. Kymes, J. J. Walline, K. Zadnik, and M. O. Gordon, “Quality of life in keratoconus,” Am J Ophthalmol,2004; vol. 138, no. 4, pp. 527–535

B. K. Armstrong, S. D. Smith, I. Romac Coc, P. Agarwal, N. Mustapha, and S. Navon, “Screening for Keratoconus in a High-Risk Adolescent Population,” Ophthalmic Epidemiol, 2021; vol. 28, no. 3, pp. 191–197,

M. Saßmannshausen, M. C. Herwig-Carl, F. G. Holz, and K. U. Loeffler, “‘Acute’ keratoconus?,” Ophthalmologe,2022; vol. 119, no. 4, pp. 400–402

X. Zhang, S. Z. Munir, S. A. Sami Karim, and W. M. Munir, “A review of imaging modalities for detecting early keratoconus,” Eye (Basingstoke), Springer Nature, 2021; vol. 35, no. 1. pp. 173–187

Y. Bykhovskaya and Y. S. Rabinowitz, “Update on the genetics of keratoconus,” Exp Eye Res, 2921; vol. 202

A. Lee and M. V. Sakhalkar, “Ocular manifestations of Noonan syndrome in twin siblings: A case report of keratoconus with acute corneal hydrops,” Indian J Ophthalmol, vol. 62, no. 12, pp. 1171–1173, Dec. 2014, doi: 10.4103/0301-4738.126992.

L. Martínez-Pérez, E. Viso, R. Touriño, F. Gude, and M. T. Rodríguez-Ares, “Clinical evaluation of meibomian gland dysfunction in patients with keratoconus,” Contact Lens and Anterior Eye, vol. 45, no. 3, Jun. 2022, doi: 10.1016/j.clae.2021.101495.

E. O. Kreps, I. Claerhout, and C. Koppen, “Diagnostic patterns in keratoconus,” Contact Lens and Anterior Eye, vol. 44, no. 3, Jun. 2021, doi: 10.1016/j.clae.2020.05.002.

T. L. A. Volatier, F. C. Figueiredo, and C. J. Connon, “Keratoconus at a Molecular Level: A Review,” Anatomical Record, vol. 303, no. 6, pp. 1680–1688, Jun. 2020, doi: 10.1002/ar.24090.

V. Mas Tur, C. MacGregor, R. Jayaswal, D. O’Brart, and N. Maycock, “A review of keratoconus: Diagnosis, pathophysiology, and genetics,” Survey of Ophthalmology, vol. 62, no. 6. Elsevier USA, pp. 770–783, Nov. 01, 2017. doi: 10.1016/j.survophthal.2017.06.009.

P. K. Akowuah, E. Kobia-Acquah, R. Donkor, J. Adjei-Anang, and S. Ankamah-Lomotey, “Keratoconus in Africa: A systematic review and meta-analysis,” Ophthalmic and Physiological Optics, vol. 41, no. 4. Blackwell Publishing Ltd, pp. 736–747, Jul. 01, 2021. doi: 10.1111/opo.12825.

A. Gordon-Shaag, M. Millodot, M. Essa, J. Garth, M. Ghara, and E. Shneor, “Is Consanguinity a Risk Factor for Keratoconus?” [Online]. Available:

Ö. Saraç, M. E. Kars, B. Temel, and N. Çağıl, “Clinical evaluation of different types of contact lenses in keratoconus management,” Contact Lens and Anterior Eye, vol. 42, no. 5, pp. 482–486, Oct. 2019, doi: 10.1016/j.clae.2019.02.013.

L. M. Imbornoni, C. N. J. McGhee, and M. W. Belin, “Evolution of Keratoconus: From Diagnosis to Therapeutics,” Klinische Monatsblatter fur Augenheilkunde, vol. 235, no. 6. Georg Thieme Verlag, pp. 680–688, Jun. 01, 2018. doi: 10.1055/s-0044-100617.

E. Atalay, O. Özalp, and N. Yıldırım, “Advances in the diagnosis and treatment of keratoconus,” Ther Adv Ophthalmol, vol. 13, p. 251584142110127, Jan. 2021, doi: 10.1177/25158414211012796.

A. E. Davidson, S. Hayes, A. J. Hardcastle, and S. J. Tuft, “The pathogenesis of keratoconus,” Eye (Basingstoke), vol. 28, no. 2, pp. 189–195, 2014, doi: 10.1038/eye.2013.278.

L. E. Masiwa and V. Moodley, “A review of corneal imaging methods for the early diagnosis of pre-clinical Keratoconus,” Journal of Optometry, 2020. vol. 13, no. 4. Spanish Council of Optometry, pp. 269–275



How to Cite

Ardian Reza Putra, Sangging, P. R. A., & Himayani, R. . (2023). Literature Review : Keratoconus . Medical Profession Journal of Lampung, 13(4.1), 166-173.

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