Fluctuating topography

We place a lot of reliance on our “technology”, but how much variability is there in our technology, and our body? It is an important consideration to accurately interpret tests and make recommendations on treatment.

Fluctuating topography of the cornea
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This young man presented with early “keratoconus”, and counselled on eye rubbing

Over a year, sequential topography maps showed fluctuation, but no deterioration.

Viewed in isolation, one could argue both progression/worsening of disease, as well as regression/improvement. It just depends on what time point you choose.

Stand back and take a longer look over time, and there is no deterioration.

Always take a deep breath before rushing in to treat subtle disease!

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