Cornea plana—clinical features, videokeratometry, and management

Editor,—Cornea plana is a rare anomaly in which the corneal radius of curvature is larger than normal producing high hypermetropia with astigmatism and poor acuity in most cases. Myopic astigmatism can also occur. We describe three patients with this anomaly including videokeratometry images. ### CASE REPORTS #### Case 1 A 25 year old woman complained of a deterioration in visual acuity over recent years. Her parents, three brothers, and an older sister (examined by the authors) had no manifest ocular problems. Corrected visual acuities were 6/24, N24 right eye and 6/60, N24 left eye with refractive errors of −2.25/+1.50 × 165° and −7.50/+2.50 × 20° respectively. Examination revealed apparently small corneas with peripheral opacification—particularly superiorly (Fig 1)—giving a horizontally oval configuration. There was central stromal thickening and faint opacity (Fig 1). Automated videokeratoscopy confirmed marked corneal flattening with regular astigmatism (Fig 2). There were no abnormal features affecting the iris or crystalline lens. The intraocular tensions (Goldmann tonometry) were right eye 11 mm Hg and left eye 10 mm Hg. Gonioscopy demonstrated open drainage angles with normal angle structures. …