Journal of Ophthalmic and Optometric Sciences

Abstract

Case Report: A 30-year-old male presented with progressive blurred vision and a suspected family history of KCN. Clinical examination revealed high astigmatism, a scissor reflex on retinoscopy, and fine horizontal striae in the posterior stroma and Descemet’s membrane of both corneas, resembling Vogt’s striae. Pentacam imaging confirmed the diagnosis of KCN, demonstrating central corneal thinning, elevated front and back elevation maps, and high dioptric power points in the curvature map of both eyes. Due to intolerance to rigid gas permeable (RGP) lenses, deep anterior lamellar keratoplasty (DALK) was performed as the definitive treatment.
Conclusion: This case highlights a rare bilateral presentation of horizontal Vogt’s striae in KCN, an uncommon slit-lamp finding. The presence of these atypical stress lines may be attributed to mechanical stretching or corneal distortion induced by the cone. Recognizing such rare variations can enhance the understanding of KCN pathophysiology and aid in its clinical diagnosis and management.