Clinical Profile of Keratoconus Patients at the Philippine General Hospital
Pablito F. Sandoval Jr., MD1,2, George Michael N. Sosuan, MD1, Reginald Robert G. Tan, MD1,3, Ruben Lim Bon Siong, MD1,3
1Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila, Philippines
2Department of Ophthalmology, Ospital ng Maynila Medical Center, Manila, Philippines
3Eye Institute, St. Luke’s Medical Center, Quezon City, Philippines
Correspondence: Pablito F. Sandoval Jr., MD
Office Address: Department of Ophthalmology and Visual Sciences, Sentro Oftalmologico Jose Rizal, Philippine General Hospital, University of the Philippines Manila, Taft Avenue, Ermita, Manila, Philippines
Office Phone Number: +63285548400 local 8502
Email Address: pabs.sandoval@gmail.com
Disclosures: The authors report no conflict of interest.
ABSTRACT
Objectives: This study described the clinical profile of patients with keratoconus at a single tertiary referral hospital.
Methods: This was a single-center, retrospective, cross-sectional study that reviewed medical records of patients diagnosed with keratoconus from January 2015 to August 2022. Data on the clinical profile, intervention, and clinical outcomes were collected from the chart review.
Results: Forty (40) patients (79 eyes) were included in the study. Majority (98%) had bilateral disease in which 22 (55.5%) were affected asymmetrically. The mean age was 21 years. Most patients (72.5%) were male. Blurring of vision was the chief complaint in all patients. Atopy was present in 23 patients (57.5%). History of vigorous eye rubbing was present in 31 (77.5%). The mean interval from onset of symptoms to consult was 46.4 ± 33.38 months. The mean pinhole corrected distance visual acuity was 0.47 ± 0.41 (Snellen equivalent of 20/59). The average spherical equivalent was -7.48D ± 6.99D. Corneal protrusion on slit-lamp biomicroscopy was seen in 78 eyes (98.7%). Other findings included Fleischer ring (53.2%), Vogt’s striae (19.0%), and apical corneal scar (24.0%). Only one eye (1.3%) had no corneal findings. Thirty-nine eyes (49.3%) were classified as advanced- severe keratoconus. Rigid contact lens was planned for 60 eyes (75.9%). Sixty-two eyes (78.5%) were for collagen cross-linking. Deep anterior lamellar keratoplasty was planned in 10 eyes (12.7%) and penetrating keratoplasty in two eyes (2.5%).
Conclusion: Keratoconus at the Philippine General Hospital was most frequently seen in young males and asymmetrically affects both eyes. Patients consulted relatively late and presented with a more advanced stage of the disease. History of ocular allergy and eye rubbing were significant risk factors. Improving awareness of this condition must be emphasized to detect keratoconus earlier.
Keywords: keratoconus, cornea, demography, Philippines, atopy