Diplopia and Keratoconus Risk in Children - Ophthalmology

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Diplopia, or double vision, in children can be a concerning symptom, particularly when it persists for an extended period, as in your child's case. The presence of astigmatism, as indicated by the high cylindrical values in the eye examination results, can contribute to visual disturbances, including diplopia. When the eye's curvature is irregular, it can cause light to focus at multiple points on the retina, leading to blurred or double vision.
In your child's case, the significant astigmatism (with values of -2.75D and -1.75D) suggests that corrective lenses may be necessary to help improve visual clarity and potentially alleviate the diplopia. It's important to note that astigmatism can often be corrected with glasses, which may also help in reducing the symptoms of double vision.

Regarding keratoconus, this is a progressive eye disease where the cornea thins and bulges into a cone-like shape, leading to distorted vision. While keratoconus can be associated with high levels of astigmatism, it is not a direct cause of diplopia. However, children with keratoconus may experience visual distortions that could mimic or exacerbate symptoms of diplopia.
The risk factors for developing keratoconus include a family history of the condition, certain systemic diseases (like Down syndrome or Ehlers-Danlos syndrome), and eye rubbing, which can be common in children. Given that your child is experiencing diplopia and has significant astigmatism, it would be prudent to monitor for any additional symptoms that might suggest keratoconus, such as increased sensitivity to light, frequent changes in prescription, or visual distortions.

To assess the risk of keratoconus in your child, an eye care professional may perform a corneal topography test, which provides detailed maps of the cornea's shape and curvature. This test can help identify any irregularities that may indicate keratoconus.

In summary, while your child's diplopia and astigmatism warrant attention and corrective measures, the risk of keratoconus should be evaluated through further testing. It is essential to follow up with an eye care specialist who can provide a comprehensive assessment and recommend appropriate interventions. Early detection and management can significantly improve visual outcomes and quality of life for children experiencing these symptoms.