In keratoconus, which finding best documents true PROGRESSION of the disease?

• A Increase in spectacle cylinder power alone
• B Development of Fleischer ring
• C Decrease in uncorrected visual acuity measured once
• D Increase in maximum keratometry (Kmax) of 1.0 D or more between visits ✓

Explanation

Progression is documented tomographically, conventionally as an increase in Kmax of 1.0 B or more over time, often combined with increasing posterior elevation and progressive thinning. This objective criterion decides when to perform cross-linking, since CXL is indicated only for proven progression. Refraction fluctuates with accommodation and tear film, a single acuity reading is unreliable, and Fleischer ring indicates iron deposition in established disease, not activity.

Reference: Yanoff and Duker, Ophthalmology, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.