Detachment of Descemets-membrane In A Case of Keratoconus

The authors (A.M.B., P.E.B., R.R., and C.B.) report on an unusual case of spontaneous detachment of Descemet's membrane occurring in an anomalous keratoconus, which demonstrates a globular profile and a regular astigmatism as in keratoglobus. The latter was excluded since the ectasia was acquired in later life and the cornea was thinned only in the central zone even though a Fleischer ring and Vogt's lines were absent. The patient subsequently underwent penetrating keratoplasty and the removed corneal button was examined by light microscopy confirming a detachment of Descemet's membrane. The temporal lip of the original tear was rolled up in a typical clock-spring manner. The patient had suffered for many years from atopic dermatitis, which is a known condition to be associated with keratoconus. General examination of the patient revealed a lean build, arachnodactyly, thin skin with a velvety texture, livido reticularis in the lower limbs, and marked dental neglect. Although an underlying mesodermal abnormality was suspected, there were not enough elements to fit this case into a recognized disease pattern.