H18.713 Corneal ectasia, bilateral

Name of the Condition

• Corneal ectasia, bilateral
• Also known as keratectasia or keratoconus when affecting both eyes.

Summary

• Corneal ectasia is a progressive eye disorder characterized by thinning and bulging of the cornea. This leads to a cone-like shape, causing visual distortion. When it affects both eyes, it is referred to as bilateral corneal ectasia.

Causes

• The exact cause is unknown, but it can be associated with genetic predisposition, eye injury, or complications following procedures like LASIK surgery.

Risk Factors

• Family history of the condition.
• Frequent eye rubbing or chronic eye irritation.
• Certain connective tissue disorders.

Symptoms

• Blurred or distorted vision.
• Increased sensitivity to light.
• Frequent changes in eyeglass prescription.
• Ghost images or multiple images (monocular diplopia).

Diagnosis

• Thorough eye examination including corneal topography.
• Pachymetry to measure corneal thickness.
• Refraction assessment to measure visual acuity.

Treatment Options

• Eyeglasses or Soft Contact Lenses: For mild cases to correct vision.
• Rigid Gas-Permeable Contact Lenses: To maintain regular corneal shape and improve vision.
• Corneal Cross-linking: To strengthen the corneal structure and halt progression.
• Surgery: Options like Intacs corneal implants or corneal transplant for advanced cases.

Prognosis and Follow-Up

• Early diagnosis and treatment can slow progression and improve vision.
• Regular follow-ups are crucial to monitor changes in corneal shape and vision.

Complications

• Severe visual impairment if untreated.
• Scarring of the cornea, affecting vision quality.
• Need for a potential corneal transplant in advanced cases.

Lifestyle & Prevention

• Avoid excessive eye rubbing.
• Protect eyes from irritants and trauma with protective eyewear.
• Regular eye check-ups, especially if there is a family history.

When to Seek Professional Help

• Sudden changes in vision.
• Increased difficulty seeing at night.
• Halos or glaring around lights.

Additional Resources

• The American Academy of Ophthalmology: aao.org
• The National Keratoconus Foundation: NKCF.org

Tips for Medical Coders

• Ensure correct bilateral coding by noting both eyes are affected.
• Cross-reference with patient history for any related procedural complications (e.g., post-LASIK).
• Avoid confusing with monocular cases of corneal ectasia.