Corneal ectasia: From Precision diagnostics to personalised management

Corneal ectasia represents a progressive spectrum of disorders that challenge clinicians in both diagnosis and long‑term management. Historically, keratoconus and related ectatic corneal diseases were detected only after significant vision loss, often culminating in corneal transplantation. Recent advances in imaging technology, artificial intelligence (AI), and corneal biomechanics have revolutionised our ability to identify subclinical disease, refine classification systems, and guide personalised interventions. Despite these advances, early identification and individualised treatment strategies remain inconsistent worldwide. The integration of multimodal imaging, machine learning, and biomechanical models offers a promising route toward predictive, preventive, and precision ophthalmology. Gaps remain, however, in translating these advances into standardised diagnostic pathways, ensuring equitable access to stabilising therapies, and achieving sustainable visual rehabilitation outcomes for patients globally.This Research Topic aims to unite clinicians, scientists, and innovators to advance corneal ectasia management through precision diagnostics, disease stabilisation, and visual rehabilitation. The objective is to highlight how cutting‑edge technologies—ranging from Scheimpflug tomography and high‑frequency ultrasound to AI‑based pattern recognition—can detect the earliest signs of biomechanical weakening, and how tailored interventions such as collagen cross‑linking (CXL) and customised refractive procedures can preserve vision. We seek to strengthen the link between diagnostic sophistication and meaningful clinical outcomes, fostering approaches that delay or eliminate the need for corneal transplantation.The scope of this Research Topic encompasses advances from detection to long‑term visual restoration. Studies may address basic, translational, or clinical aspects, with emphasis on quantitative analytics, innovative treatment design, and patient‑centred rehabilitation. To gather further insights in this evolving field, we welcome articles addressing, but not limited to, the following themes:- Early detection and screening: Evaluation of AI and machine learning algorithms for subclinical keratoconus detection; epithelial thickness mapping using OCT; and advances in corneal biomechanics.- Innovations in stabilisation: Novel and customised protocols in corneal collagen cross‑linking (CXL); combination therapies to arrest disease progression.- Visual rehabilitation strategies: Clinical outcomes of rigid contact lens fitting; synthetic and allograft intracorneal ring segments; customised excimer‑laser and lens‑based refractive procedures; and surgical management of hydrops and lamellar keratoplasty.- Pathogenesis and risk factors: Genetic determinants of ectasia; the biomechanical and biochemical effects of eye rubbing; and the influence of the ocular surface environment on disease progression.- Integration of multimodal diagnostics: Combining tomography, pachymetric mapping, and dynamic biomechanical modelling for predictive algorithms and patient‑specific treatment planning. Topic editors: Parwez Hossain, Zahra Ashena Source: https://www.frontiersin.org/research-topics/83874/corneal-ectasia-from-precision-diagnostics-to-personalised-management