ICD-10: H18.711

Corneal ectasia is a progressive condition characterized by the thinning and bulging of the cornea, which can lead to significant visual impairment. The ICD-10-CM code H18.711 specifically refers to corneal ectasia affecting the right eye. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Corneal Ectasia

Definition

Corneal ectasia is defined as a non-inflammatory condition where the cornea becomes progressively thinner and protrudes forward, resulting in a distorted shape. This condition can lead to various visual disturbances, including blurred vision, sensitivity to light, and increased glare.

Etiology

The exact cause of corneal ectasia is not fully understood, but it is often associated with several factors:
- Genetic predisposition: Conditions such as keratoconus, which is a common form of corneal ectasia, may have a hereditary component.
- Environmental factors: Eye rubbing, exposure to UV light, and certain contact lens wear patterns can contribute to the development of ectasia.
- Post-surgical changes: Corneal ectasia can occur following refractive surgeries, such as LASIK, particularly in patients with pre-existing corneal irregularities.

Symptoms

Patients with corneal ectasia may experience a range of symptoms, including:
- Blurred or distorted vision
- Increased sensitivity to light
- Frequent changes in prescription glasses or contact lenses
- Halos or glare around lights, especially at night

Diagnosis

Diagnosis of corneal ectasia typically involves:
- Clinical examination: An eye care professional will assess the cornea's shape and thickness.
- Corneal topography: This imaging technique provides detailed maps of the cornea's surface, helping to identify irregularities.
- Pachymetry: This test measures the thickness of the cornea, which is crucial in diagnosing ectasia.

Treatment Options

Treatment for corneal ectasia varies based on the severity of the condition and may include:
- Corrective lenses: Glasses or specialized contact lenses can help improve vision.
- Cross-linking: A procedure that strengthens corneal tissue to halt progression.
- Surgical options: In advanced cases, procedures such as corneal transplant or implantation of intrastromal corneal rings may be considered.

ICD-10-CM Code H18.711

Specifics of the Code

• Code: H18.711
• Description: Corneal ectasia, right eye
• Classification: This code falls under the category of diseases of the cornea, specifically indicating that the condition affects the right eye.

Importance of Accurate Coding

Accurate coding is essential for proper diagnosis, treatment planning, and insurance reimbursement. The specificity of H18.711 allows healthcare providers to document the condition clearly, ensuring that patients receive appropriate care tailored to their needs.

Conclusion

Corneal ectasia, particularly as denoted by the ICD-10-CM code H18.711 for the right eye, is a significant ocular condition that requires careful diagnosis and management. Understanding the clinical aspects, symptoms, and treatment options is crucial for healthcare providers to offer effective care and improve patient outcomes. Regular monitoring and timely intervention can help manage the condition and preserve vision.

Corneal ectasia, specifically coded as H18.711 in the ICD-10-CM classification, refers to a condition characterized by the progressive thinning and bulging of the cornea, leading to visual impairment. This condition can significantly affect a patient's quality of life and is often associated with other ocular disorders, particularly keratoconus. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with corneal ectasia of the right eye.

Clinical Presentation

Corneal ectasia typically manifests as a gradual deterioration of vision, which may be accompanied by various ocular symptoms. The condition can arise post-surgically, particularly after procedures like LASIK, or it may develop idiopathically.

Signs and Symptoms

1. Visual Disturbances:
   - Blurred Vision: Patients often report progressive blurriness, particularly at night or in low-light conditions.
   - Distorted Vision: Straight lines may appear wavy or distorted due to irregular corneal shape.
   - Increased Sensitivity to Light: Photophobia can occur, making bright lights uncomfortable.

2. Ocular Discomfort:
   - Eye Strain: Patients may experience fatigue or discomfort after prolonged visual tasks.
   - Dryness or Irritation: Some individuals report sensations of dryness or irritation in the affected eye.

3. Corneal Changes:
   - Thinning of the Cornea: Examination may reveal localized thinning, particularly in the central or inferior regions of the cornea.
   - Keratometry Findings: Increased corneal curvature can be observed, indicating the ectatic process.

4. Other Symptoms:
   - Frequent Changes in Prescription: Patients may notice that their glasses or contact lens prescriptions change frequently.
   - Night Vision Problems: Difficulty seeing at night is common due to the irregular corneal surface.

Patient Characteristics

Corneal ectasia can affect individuals of various ages, but certain characteristics and risk factors are commonly observed:

1. Age:
   - Most commonly diagnosed in young adults, particularly those in their late teens to early thirties.

2. Gender:
   - There is no significant gender predisposition, although some studies suggest a slight male predominance.

3. Family History:
   - A family history of keratoconus or other corneal disorders may increase the risk of developing corneal ectasia.

4. Previous Eye Surgery:
   - A history of refractive surgery, especially LASIK, is a notable risk factor for developing corneal ectasia.

5. Allergies and Eye Rubbing:
   - Patients with a history of atopic conditions or habitual eye rubbing may be at higher risk due to mechanical stress on the cornea.

6. Other Ocular Conditions:
   - Conditions such as Down syndrome, Ehlers-Danlos syndrome, and other connective tissue disorders may be associated with a higher incidence of corneal ectasia.

Conclusion

Corneal ectasia, particularly in the right eye as indicated by the ICD-10 code H18.711, presents with a range of visual disturbances and ocular discomfort. Understanding the clinical signs, symptoms, and patient characteristics is crucial for timely diagnosis and management. Early intervention, including corneal cross-linking or other surgical options, can help stabilize the condition and improve visual outcomes for affected individuals. Regular follow-up and monitoring are essential for managing this progressive condition effectively.

Corneal ectasia, specifically coded as H18.711 in the ICD-10-CM system, refers to a condition characterized by the progressive thinning and bulging of the cornea in the right eye. This condition can lead to significant visual impairment and is often associated with other corneal disorders. Below are alternative names and related terms that are commonly associated with corneal ectasia:

Alternative Names for Corneal Ectasia

1. Keratoconus: This is the most common form of corneal ectasia, where the cornea becomes cone-shaped, leading to distorted vision.
2. Pellucid Marginal Degeneration: A specific type of corneal ectasia that typically affects the lower part of the cornea, causing thinning and protrusion.
3. Corneal Thinning: A general term that can describe the thinning aspect of corneal ectasia.
4. Corneal Bulging: Refers to the outward protrusion of the cornea, a hallmark of ectatic conditions.

Related Terms

1. Corneal Topography: A diagnostic tool used to map the surface curvature of the cornea, essential for diagnosing and managing corneal ectasia.
2. Corneal Collagen Cross-Linking: A treatment option aimed at strengthening the corneal structure to halt the progression of ectasia.
3. Visual Distortion: A symptom often associated with corneal ectasia, where vision becomes blurred or distorted due to irregular corneal shape.
4. Ectatic Corneal Disease: A broader term that encompasses various conditions characterized by corneal ectasia, including keratoconus and pellucid marginal degeneration.

Conclusion

Understanding the alternative names and related terms for ICD-10 code H18.711 is crucial for healthcare professionals involved in the diagnosis and treatment of corneal ectasia. These terms not only aid in accurate coding and billing but also enhance communication among medical practitioners regarding patient care and management strategies.

Corneal ectasia, classified under the ICD-10-CM code H18.711, refers to a condition where the cornea becomes progressively thinner and bulges outward, leading to visual impairment. The diagnosis of corneal ectasia involves a combination of clinical evaluation, patient history, and specific diagnostic tests. Below are the key criteria used for diagnosing this condition:

Clinical Evaluation

1. Patient History:
   - A thorough history is essential, including any previous eye surgeries (e.g., LASIK), family history of keratoconus or other corneal diseases, and symptoms such as blurred vision, glare, or halos around lights.

2. Symptoms:
   - Patients often report progressive vision changes, which may include increased sensitivity to light, distortion of images, and difficulty with night vision.

Diagnostic Tests

1. Corneal Topography:
   - This is a critical diagnostic tool that maps the surface curvature of the cornea. In corneal ectasia, topography typically shows a characteristic steepening of the cornea, often in a cone-like shape, which is indicative of the condition[1][2].

2. Pachymetry:
   - This test measures the thickness of the cornea. In cases of ectasia, the cornea is often thinner than normal, particularly at the apex of the cone[3].

3. Slit-Lamp Examination:
   - A slit-lamp examination allows the ophthalmologist to assess the cornea's shape and surface. Signs of corneal ectasia may include irregular astigmatism and changes in the corneal structure[4].

4. Refraction:
   - A refraction test helps determine the degree of visual impairment and the presence of irregular astigmatism, which is common in corneal ectasia[5].

5. Other Imaging Techniques:
   - Advanced imaging techniques, such as Scheimpflug imaging or optical coherence tomography (OCT), may also be utilized to provide detailed information about corneal structure and thickness[6].

Conclusion

The diagnosis of corneal ectasia (ICD-10 code H18.711) is multifaceted, relying on a combination of patient history, clinical symptoms, and advanced diagnostic testing. Early detection is crucial for managing the condition effectively, as it can lead to significant visual impairment if left untreated. If you suspect corneal ectasia, it is essential to consult an eye care professional for a comprehensive evaluation and appropriate management options.

References

1. Clinical Policy: Corneal Topography.
2. Medical Policy Corneal Topography.
3. Billing and Coding: Computerized Corneal Topography.
4. CG-SURG-105 Corneal Collagen Cross-Linking.
5. Billing and Coding: Scanning Computerized Ophthalmic.
6. Corneal Cross-Linking for Keratoconus and Ectasia, MPM.

Corneal ectasia, particularly as classified under ICD-10 code H18.711, refers to a condition where the cornea becomes progressively thinner and bulges outward, leading to visual impairment. This condition can arise from various factors, including keratoconus, post-surgical changes (such as after LASIK), or other corneal disorders. The management of corneal ectasia typically involves a combination of non-surgical and surgical approaches, depending on the severity of the condition and the degree of visual impairment.

Standard Treatment Approaches

1. Non-Surgical Treatments

Contact Lenses

• Specialized Contact Lenses: Rigid gas permeable (RGP) lenses or scleral lenses are often prescribed to improve vision by providing a smooth refractive surface over the irregular cornea. These lenses can help manage the visual distortion caused by ectasia and are often the first line of treatment for mild to moderate cases[1].

Corneal Collagen Cross-Linking (CXL)

• Procedure Overview: CXL is a minimally invasive procedure that strengthens the corneal tissue by using riboflavin (vitamin B2) and ultraviolet light. This treatment aims to halt the progression of ectasia and is particularly effective in early to moderate cases[2].
• Indications: It is indicated for patients with progressive keratoconus or corneal ectasia post-refractive surgery, especially when the cornea is still relatively thick[3].

2. Surgical Treatments

Intacs

• Intrastromal Corneal Ring Segments: Intacs are small, curved devices implanted in the cornea to flatten the corneal curvature and improve vision. This option is typically considered for patients who are not suitable for contact lenses or who have not responded to other treatments[4].

Corneal Transplantation

• Penetrating Keratoplasty (PKP): In advanced cases where vision cannot be adequately corrected with lenses or other treatments, a corneal transplant may be necessary. This involves replacing the affected cornea with donor tissue[5].
• Deep Anterior Lamellar Keratoplasty (DALK): This is a partial thickness transplant that preserves the patient's endothelium, which can be beneficial in certain cases of ectasia[6].

3. Monitoring and Follow-Up

• Regular follow-up appointments are crucial for monitoring the progression of corneal ectasia and the effectiveness of the chosen treatment. This may include visual acuity tests, corneal topography, and pachymetry to assess corneal thickness and shape changes over time[7].

Conclusion

The management of corneal ectasia (ICD-10 code H18.711) involves a tailored approach based on the severity of the condition and the patient's visual needs. Non-surgical options like specialized contact lenses and corneal collagen cross-linking are effective for many patients, while surgical interventions may be necessary for more advanced cases. Continuous monitoring is essential to adapt treatment plans as the condition evolves. If you or someone you know is experiencing symptoms of corneal ectasia, consulting with an ophthalmologist is crucial for appropriate diagnosis and management.

References

1. Specialized contact lenses for corneal ectasia management.
2. Overview of corneal collagen cross-linking.
3. Indications for corneal collagen cross-linking in ectasia.
4. Use of Intacs in corneal ectasia treatment.
5. Corneal transplantation options for advanced ectasia.
6. Benefits of deep anterior lamellar keratoplasty.
7. Importance of regular follow-up in managing corneal ectasia.