CLINICAL DETECTION OF UNILATERAL KERATOCONUS

Purpose: To determine the incidence of true unilateral keratoconus on the basis of computerised corneal topography in a group with clinicall y diagnosed unilateral keratoconus. Methods: Retrospective review of 2 95 patients with keratoconus identified 51 patients with a provisional diagnosis of unilateral keratoconus. Thirty-one of these patients wer e re-examined clinically and 21 patients met the criteria for a clinic al diagnosis of unilateral keratoconus. Computerised corneal topograph ic analysis (Tomey TMS) was then performed. Results: In a group of 21 patients with clinically diagnosed unilateral keratoconus, computerise d corneal topographic analysis identified 14 (67%) patients with bilat eral keratoconus and seven (33%) patients with true unilateral keratoc onus. Contact lens wear had no significant influence (P=0.76) on the t opographical diagnosis of keratoconus in the clinically unaffected fel low eye. The estimated incidence of true unilateral keratoconus in the cohort of 295 patients was 4%. Conclusion: Computerised corneal topog raphy improves sensitivity in detection of true unilateral keratoconus .