Dr. Shikha Gupta
Ophthalmology (Eye Care)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I got my 2.7 years old daughter's eyes checked, and she has a cylindrical number of -1 and -1.25 at 180 axis. Will it increase as she grows? Is the test done on the machine, reliable? I hope this is not a sign of keratoconus.
Hello,
Welcome to icliniq.com.
This may be a sign of keratoconus, but not for sure. It depends on the progression. If it progresses rapidly and corneal thinning occurs, then only it can be called as keratoconus. At present it is astigmatism. And you should start using glasses. Yes, it will change in future. A regular follow-up at six months intervals is required, or earlier if she complaints of poor vision.
Patient's Query
Thank you doctor,
But, can keratoconus occur in children? My doctor told me it is just a cylindrical number by birth, and small children before puberty cannot have keratoconus.
Hello,
Welcome back to icliniq.com.
We call it keratoconus if it progresses. Astigmatism goes on increasing with progressive thinning of the cornea. Initially, at a young age, there is astigmatism only. With age, it starts increasing, only then we call it keratoconus. So, it is not there at birth or the first decade of life. It starts progressing later and is diagnosed in the 20s. At present, you must use spectacles, and forget about keratoconus. I hope you got my point.
Patient's Query
Thank you doctor,
I understand, but the doctor wrote 6/7 acuity. Is it normal at this age? Or at this age children can see 6/6? Also, is there a difference between culmedrival number and keratoconus?
Hello,
Welcome back to icliniq.com.
No, 6/6 is a normal vision for adults. And adult vision is gained at six years. Sorry, what is a culmedrival number? I have not heard of it.
Patient's Query
Thank you doctor,
I do not know, but she could not read the last line, and they have written 6/7 vision. I mean she could read second last line, is it normal for a two year old? How can I rule out keratoconus or is it not needed?
Hello,
Welcome back to icliniq.com.
It is not your job to diagnose, please leave it on your doctors. And you should have faith in your doctor. Otherwise, you can get most of your answers online.
Patient's Query
Thank you doctor,
Is there a difference between a cylindrical number and keratoconus?
Hello,
Welcome back to icliniq.com.
Yes, there is a difference between a cylindrical number and keratoconus.
Patient's Query
Thank you doctor,
How can we differentiate between cylindrical number and keratoconus? Is it through pentacam?
Hello,
Welcome back to icliniq.com.
A cylindrical number means astigmatism. It is just one of the signs of keratoconus, that too irregular astigmatism. It is not just one sign which should be diagnosed as keratoconus, but many other signs are also present and I have mentioned some of them earlier also.
Patient's Query
Thank you doctor,
We went to the doctor again today, and they dilated her eyes and checked if she could read the second last line at 20/20. And I think she is too young to read the last line. And the doctor told her cylindrical number is 0.75 in both eyes. Is it possible that with 0.75 number cylindrical, she can still read 20/20?
Hi,
Welcome back to icliniq.com.
Anything is possible.
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Ophthalmology (Eye Care)
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