Keratoconus onset after age 50.

PURPOSE: To describe the sudden clinical manifestations of keratoconus in a 51-year-old woman.

METHODS

The patient had stable annual refractions for several years with 0.50 diopters (D) astigmatism in each eye and later developed 2.00 and 6.00 D of astigmatism in the right and left eyes, respectively.

RESULTS

Topography and tomography showed definite keratoconus in the left eye and possible keratoconus in the right eye. The patient had no known family history of keratoconus and no known connective tissue disease other than fibromyalgia. She wore soft contacts for 20 years and had allergies, but did not rub her eyes. The patient was treated with corneal collagen cross-linking (CXL).

CONCLUSIONS

Although rare, ectatic changes can occur later in life without prior surgery or trauma. The patient has shown early signs of improvement with CXL despite her age.