PMC5369299_01
Anterior segment findings. (a) Diffuse illumination of right eye; (b) magnified view showing areas of iris atrophy and iris nodules (red arrow); (c and d) cobalt blue filter illumination of right eye (c) and left eye (d) showing Fleisher's ring (white arrow); (e) right eye gonioscopy of temporal angle showing broad peripheral anterior synechiae at 10-11 o'clock position (blue arrow) with smaller early adjacent synechiae (red arrows); (f) gonioscopy of temporal-superior zone showing temporal synechiae (blue arrow) and pigmented superior angle
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F1
Anterior segment examination findings have been illustrated in Fig. 1.
Color fundus photographs and specular microscopy image. (a) Right eye showing early notching in inferior neuroretinal rim and bayoneting of vessel (white arrow); (b) left eye showing healthy neuroretinal rim. (c) right eye magnified specular microscopy shows pleomorphism, polymegathism, light-dark reversal and a low cell density of 986 cells/mm2; (d) normal polygonal endothelial cells of left eye with cell density of 2414 cells/mm2
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F2
Optic disc examination [Fig. 2] showed a cup to disc ratio of approximately 0.4 in right eye with early glaucomatous changes suggested by inferior notching and inferior vessel bending (bayoneting sign). Left eye revealed normal corneal endothelium [Fig. 2].
Corneal topography. (a) Right eye showing advanced keratoconus. (b) Left eye showing moderate keratoconus. Maximum simulated keratometric value was 62.6 Diopter in right eye and 57.3 Diopter in the left eye. Posterior elevation was 0.159 mm in right eye and 0.128 mm in left eye
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F3
IIz, Bausch and Lomb, Rochester, New York, USA) established the diagnosis of KC both eyes with the right eye being more affected [Fig. 3]. Inferior-Superior difference in both eyes in the central 1-5 mm zone was more than 1.2 Diopter.
PMC5369299_02
PMC5369299_03