PURPOSE: To report a case of a 34-year-old woman presenting with keratoglobus and posterior polymorphous corneal dystrophy (PPMD). METHODS: Observational case report including ophthalmologic examination, topographic findings, and specular microscopy findings. RESULTS: This patient presented with corneal steepening on topography consistent with keratoglobus, as well as large areas of irregular polymorphous changes of the corneal endothelium on specular microscopy consistent with PPMD. CONCLUSIONS: We report the first case with clinical features of both keratoglobus and PPMD. This report brings forth the description of keratoglobus findings on Orbscan topography.

PURPOSE: To identify clinical findings associated with claw-shaped patterns on corneal topography. DESIGN: Retrospective, observational case series. METHODS: Forty eyes (26 patients) with classic claw-shaped patterns on corneal topography were identified from 3,993 Orbscan II records. They were subclassified into three groups: Group 1 (pellucid marginal degeneration [PMD] or PMD suspect); group 2 (keratoconus or keratoconus suspect); and group 3 (ectasia). The refractive and topographic indices of groups 1 and 2 were compared. RESULTS: There were nine eyes (six patients) in group 1, 27 eyes (18 patients) in group 2, and four eyes (two patients) in group 3. The mean radii of maximal anterior (2.96 mm) and posterior (3.06 mm) elevation in group 1 were significantly greater than those of group 2 (1.89 mm; P = .018 and 1.72 mm; P = .022, respectively). CONCLUSIONS: The claw-shaped pattern on corneal topography is not diagnostic of PMD; it is also seen in keratoconus.