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Posterior keratoconus
  1. Megan R Silas,
  2. Sarah M Hilkert,
  3. James J Reidy,
  4. Asim V Farooq
  1. Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, Illinois, USA
  1. Correspondence to Dr Asim V Farooq, Department of Ophthalmology and Visual Science, University of Chicago, 5841S. Maryland Ave Chicago, IL 60637, USA; asimfarooq{at}


Posterior keratoconus (PKC) is a rare, typically non-inflammatory condition that is characterised by an abnormal posterior corneal curvature, which may be accompanied by overlying stromal opacification. It is usually congenital and can be associated with other ocular and systemic abnormalities. PKC remains a clinical diagnosis, although imaging techniques including ultrasound biomicroscopy and anterior segment optical coherence tomography may be useful tools for confirmation and classification. Genetic studies should be considered, although no specific genetic defects have been identified thus far. As a potential cause of amblyopia, early diagnosis and management are crucial in maximising visual potential. Occasionally, management considerations may also include surgical intervention, such as corneal transplantation. Intraocular lens power calculation at the time of cataract surgery requires special consideration. Here, we review the present literature on PKC and consider future directions in the management of this rare entity.

  • cornea
  • embryology and development
  • anterior chamber
  • imaging

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  • Contributors AVF, SMH and JJR conceived and designed the idea for this review. AVF and JJR provided the key images. MRS gathered the relevant case reports, prepared the tables and figures and composed the initial draft. AVF, SMH and JJR provided critical revisions of the article. All authors approved the final version for publication.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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