The 'Munson's sign' in keratoconus refers to:
- A V-shaped indentation of the lower eyelid in downgaze due to the ectatic cornea ✓
- B Fleischer ring — iron deposits at the base of the cone visible on slit lamp
- C Vogt's striae — fine vertical stress lines in the deep stroma/Descemet membrane
- D Scissor reflex on retinoscopy due to irregular astigmatism
Correct answer: A. V-shaped indentation of the lower eyelid in downgaze due to the ectatic cornea
Explanation
Munson's sign is the V-shaped angulation or bulging of the lower eyelid in downgaze caused by the protuberant ectatic cone pushing against the inner aspect of the lower lid. It is a gross clinical sign of advanced keratoconus. Fleischer ring is a partial or complete iron deposit ring in the basal epithelium at the base of the cone. Vogt's striae are fine parallel stress lines in the posterior stroma/Descemet membrane perpendicular to the direction of corneal steepening. Scissors reflex is a retinoscopic finding but has no specific eponym in keratoconus.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.