Question

Munson's sign is a feature of?

• A. Keratoconus
• B. Corneal ulcer
• C. Pterygium
• D. Posterior staphyloma

Hint:

Lower-lid bulges into a V on downgaze due to a cone-shaped cornea.

Answer 1

The Correct Option is A

Step 1: Keratoconus is a progressive, non-inflammatory, bilateral ectatic disease in which the central or paracentral cornea thins and bulges forward into a cone, with the apex slightly below the centre.

Step 2: Munson's sign is the V-shaped indentation or bulging of the lower eyelid produced by the conical cornea when the patient looks downward. It is a classic clinical sign of keratoconus.

Step 3: Other characteristic findings of keratoconus include a distorted corneal (window) reflex, the Fleischer ring of iron at the cone base, the oil-drop reflex and a scissoring retinoscopic reflex. The condition starts at puberty, causes progressive irregular astigmatism and myopia, and gives glare and halos.

Step 4: Corneal ulcer, pterygium and posterior staphyloma do not produce the conical lower-lid indentation, so keratoconus is the answer.