The possible significance of the baropathic nature of keratectasias

Background: The aim was to describe the baropathic nature of the keratectasias and to examine the possible significance of intraocular pressure-elevating activities in the development and/or progression of these conditions. Methods: Articles were selected from 150 produced from a PubMed search for keratectasias and used to elucidate the biomechanics and dependence on intraocular pressure of those conditions. Results: The combination of viscoelastic and baropathic features of keratectasia indicate that elevations in intraocular pressure have the potential to contribute to the development and/or progression of these conditions. Acute events such as hydrops and perforation appear to be more or less dependent on IOP elevation. Conclusion: Development and/or progression of keratectasia might be slowed by patient counselling, which explains the dependence of keratectasia on intraocular pressure and recommends avoidance and/or moderation of activities that elevate intraocular pressure. Successful adoption of such advice could reduce rates of disease progression and the need for refitting with more expensive contact lens designs, which are often required for advanced cases, as well as reduce the need for grafting and the drain on limited availability of donor corneas.