Orbscan mapping in Ehlers-Danlos syndrome.

A candidate for refractive surgery presented with classic (type I) Ehlers-Danlos syndrome (EDS). Clinical examination revealed blue sclera, limbus-to-limbus corneal thinning, myopia, and astigmatism. Orbscan (Bausch & Lomb) pachymetry mapping provided a striking demonstration of the limbus-to-limbus thinning with a central corneal thickness of 360 microm in the right eye and 383 microm in the left eye and midperipheral corneal thickness ranging from 370 to 438 microm and 376 to 434 microm, respectively. Despite the theoretical biomechanical weakness from the thin cornea and defective collagen, regular surface topography was maintained without the development of keratoconus. Although all types of EDS remain a contraindication to laser refractive surgery, Orbscan mapping provides a valuable insight into corneal shape and thickness in this condition.