HomeAnswersOphthalmology (Eye Care)keratoconusAre ghosting and double vision signs of keratoconus?

Does increased cylindrical power in both eyes with ghosting and double vision indicate keratoconus?

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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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Published At February 7, 2023
Reviewed AtOctober 10, 2023

Patient's Query

Hello doctor,

I am a 29-year-old male. Recently I had a change in my cylindrical power from -0.75 D (right) and -1 D (left) to -1.25 D in both eyes. I am myopic, and my spherical power has remained the same for a long. However, I noticed ghosting, and double vision, especially during low light and contrasting backgrounds, like white on dark blue or black. The optometrist said he was undercorrecting my cylindrical from -1.5 D to -1.25 D. The issue is I still have the ghosting problem. Got my post-mydriatic test done and still got the same number that my optometrist on the refractometer generated. While the next two days after PMT was very difficult, and the ghosting increased slightly. Got my corneal topography done, and the report was negative for keratoconus, but I was in the risk group due to my steep corneal curvature. My question is, is it normal to have some vertical (only vertical) ghosting in astigmatism at 180 degrees? Can I try the cylindrical correction of 1.5 D to remove the ghosting? Or this ghosting problem will remain all life long. Also, as my age is 29 and the progressive disease keratoconus usually starts in teenage and is progressive in the initial years, how likely is it that these symptoms of mine are very early stages of it? Also, can I get corneal cross-linking done even if I am at risk? As I do not have a problem wearing glasses (I have been living with those since my secondary school days), can this thing be corrected with my current prescription (-2.75 S, -1.25 cylindrical x 180 in the right and -2.5 S, -1.25 cylindrical x 180 in left eye) by increasing the cylindrical power to -1.5 D, as I have only double vertical vision? Thank you.

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

I have seen your reports (attachments removed to protect the patients identity) on the axial length and the corneal topography pachymetry. If increasing the cylindrical power helps reduce the ghost images, then you can do so. Yes, you have steep corneas, and there are chances it may progress to keratoconus, but in my opinion, the chances are less. However, I suggest you keep it under close observation with regular corneal topography. Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sheikh Zubair Abdul Razzak
Dr. Sheikh Zubair Abdul Razzak

Ophthalmology (Eye Care)

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