Sensory exotropia due to keratoconus and review of the literature
We present the case of a 17-year-old boy with bilateral keratoconus, exotropia, and a nodular lesion of the bulbar conjunctiva in the left eye. A prism cover test revealed a 45 prism D exodeviation (). The aligned eye was the right eye and the keratoconus in this eye was of late onset. Vision in the left eye was poor and the keratoconus was advanced in this eye. The patient has a corrected visual acuity of 6/9 in his better and aligned eye and an acuity of 1/60 in the affected eye. Keratometric measures were 42.75 D at an axis of 28° and 49.0 D at an axis of 118° in the right eye, and 52.0 D at an axis of 154° and 58.75 D at an axis of 64° in the left eye. SimK1 was 45.24 D at an axis of 113° and Sim K2 was 42.75 D at an axis of 25° in the right eye. Sim K of the left eye could not be obtained because of a high steep keratometry value. Refraction in the right eye was +1.5, −7.5 × 25° and refraction in the left eye could not be obtained ().