Megalocornea, anterior megalophthalmos, keratoglobus and associated anterior segment disorders: A review.

Megalocornea and anterior megalophthalmos (megalocornea spectrum) disorders are typically defined by corneal diameter > 12.5 mm in the absence of elevated intraocular pressure. Clinical features overlap with keratoglobus but are distinct from buphthalmos and severe (globus) keratoconus. Megalocornea spectrum disorders and keratoglobus are primarily congenital disorders, often with syndromic associations; both can present with large and thin corneas, creating difficulty in diagnosis, however, only keratoglobus is typically progressive. Molecular genetics provide significant insight into underlying aetiologies. Nonetheless, careful clinical assessment remains intrinsic to diagnosis. Surgical management can be challenging due to the enlarged ciliary ring and weakened zonules in megalocornea spectrum disorders and the extreme corneal thinning of keratoglobus. In this review, the established literature on measurement of corneal diameter, diagnosis of megalocornea, anterior megalophthalmos and keratoglobus, differentiation from severe keratoconus, recent molecular genetics research and key surgical modalities in the management of these rare disorders are outlined and discussed.

Rubeola keratitis emergence during a recent measles outbreak in New Zealand.

INTRODUCTION Measles is a highly contagious disease caused by the rubeola virus. It can result in ocular complications such as conjunctivitis and keratitis, which will be encountered in general practice. Cases usually resolve without sequelae, but may progress to corneal perforation if left untreated. AIM We present two cases of rubeola keratitis secondary to measles infection. METHODS This report is about a retrospective review of data from two patients who presented to the eye department with rubeola keratitis in the midst of the recent measles outbreak in New Zealand. RESULTS Both patients presented with decreased visual acuity approximately 2 weeks after being diagnosed with measles. One of them was unvaccinated, whereas the other had no documentation of previous vaccination. Both were healthy and immunocompetent individuals. There was no evidence of corneal perforation or retinopathy on examination. Both patients regained their baseline visual acuity after treatment with fluorometholone eye drops. DISCUSSION Despite the existence of a safe and effective vaccine, there were more than 2000 cases of measles in the recent outbreak in New Zealand. The lack of vaccination is one of the primary causes of rubeola keratitis. These cases highlight the effects of measles infection from an ophthalmology perspective and reinforce the paramount importance of getting vaccinated.