{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:36:57Z","timestamp":1787657817407,"version":"build-2736575974"},"reference-count":48,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>This paper provides comprehensive insights into the cornea and its diseases, with a particular focus on keratoconus. This paper explores the cornea\u2019s function in maintaining ocular health, detailing its anatomy, pathological conditions, and the latest developments in diagnostic techniques. Keratoconus is discussed extensively, covering its subtypes, etiology, clinical manifestations, and the application of the Q-value for quantification. Several diagnostic techniques, such as corneal topography, are crucial points of discussion. This paper also examines the use of machine learning models, specifically Decision Tree and Nearest Neighbor Analysis, which enhance the accuracy of diagnosing based on topographical corneal parameters from corneal topography. These models provide valuable insights into disease progression and aid in clinical decision making. Integrating these technologies in medical research opens promising avenues for enhanced disease detection. Our findings demonstrate the effectiveness of Decision Tree and Nearest Neighbor Analysis in classifying and predicting conditions based on corneal parameters. The Decision Tree achieved classification accuracy of 62% for training and 65.7% for testing, while Nearest Neighbor Analysis yielded 65.4% for training and 62.6% for holdout samples. These models offer valuable insights into the progression and severity of keratoconus, aiding clinicians in treatment and management decisions.<\/jats:p>","DOI":"10.3390\/bioengineering11121198","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T04:20:12Z","timestamp":1732681212000},"page":"1198","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Advances in Corneal Diagnostics Using Machine Learning"],"prefix":"10.3390","volume":"11","author":[{"given":"Noor T.","family":"Al-Sharify","sequence":"first","affiliation":[{"name":"Department of Electrical & Electronic Engineering, College of Engineering, Universiti Tenaga Nasional, Kajang 43000, Malaysia"},{"name":"Medical Instrumentation Engineering Department, Al-Esraa University College, Baghdad 10069, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2040-4454","authenticated-orcid":false,"given":"Salman","family":"Yussof","sequence":"additional","affiliation":[{"name":"Institute of Informatics and Computing in Energy, Universiti Tenaga Nasional, Kajang 43000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9812-0718","authenticated-orcid":false,"given":"Nebras H.","family":"Ghaeb","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Department, Al Khwarizmi Engineering College, University of Baghdad, Baghdad 10011, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3870-3815","authenticated-orcid":false,"given":"Zainab T.","family":"Al-Sharify","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Al Hikma University College, Baghdad 10052, Iraq"},{"name":"School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK"},{"name":"Environmental Engineering Department, Mustansiriyah University, Baghdad 10052, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husam Yahya","family":"Naser","sequence":"additional","affiliation":[{"name":"Department of Electrical & Electronic Engineering, College of Engineering, Universiti Tenaga Nasional, Kajang 43000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7468-2436","authenticated-orcid":false,"given":"Sura M.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Electrical & Electronic Engineering, College of Engineering, Universiti Tenaga Nasional, Kajang 43000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ong Hang","family":"See","sequence":"additional","affiliation":[{"name":"Department of Electrical & Electronic Engineering, College of Engineering, Universiti Tenaga Nasional, Kajang 43000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leong Yeng","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Electrical & Electronic Engineering, College of Engineering, Universiti Tenaga Nasional, Kajang 43000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107709","DOI":"10.1016\/j.exer.2019.107709","article-title":"Corneal injury: Clinical and molecular aspects","volume":"186","author":"Barrientez","year":"2019","journal-title":"Exp. Eye Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1097\/OPX.0000000000001578","article-title":"Safety and efficacy of scleral lenses for keratoconus","volume":"97","author":"Fuller","year":"2020","journal-title":"Optom. Vis. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ali\u00f3, J.L. (2017). Keratoconus: Recent Advances in Diagnosis and Treatment, Springer International Publishing.","DOI":"10.1007\/978-3-319-43881-8"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2705","DOI":"10.2147\/OPTH.S392665","article-title":"Keratoconus diagnosis and treatment: Recent advances and future directions","volume":"17","author":"Bui","year":"2023","journal-title":"Clin. Ophthalmol."},{"key":"ref_5","unstructured":"Pradeep, T., Mehra, D., and Le, P.H. (2023). Histology, Eye. StatPearls, StatPearls Publishing."},{"key":"ref_6","unstructured":"Holland, E.J., Mannis, M.J., and Lee, W.B. (2013). Ocular Surface Disease: Cornea, Conjunctiva and Tear Film, E-Book: Expert Consult-Online and Print; Elsevier Health Sciences."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"190","DOI":"10.4103\/ijo.IJO_646_17","article-title":"Anatomy of cornea and ocular surface","volume":"66","author":"Sridhar","year":"2018","journal-title":"Indian J. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Joukal, M. (2017). Anatomy of the human visual pathway. Homonymous Visual Field Defects, Springer.","DOI":"10.1007\/978-3-319-52284-5_1"},{"key":"ref_9","unstructured":"Grierson, I. (2000). The Eye Book: Eyes and Eye Problems Explained, Liverpool University Press."},{"key":"ref_10","unstructured":"Albert, D., Miller, J., Azar, D., and Young, L.H. (2021). Corneal Physiology: Corneal Form and Function. Albert and Jakobiec\u2019s Principles and Practice of Ophthalmology, Springer."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/bs.pmbts.2015.04.001","article-title":"Overview of the cornea: Structure, function, and development","volume":"134","author":"Eghrari","year":"2015","journal-title":"Prog. Mol. Biol. Transl. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Atchison, D.A., and Smith, G. (2023). Optics of the Human Eye, CRC Press. [2nd ed.].","DOI":"10.1201\/9781003128601"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Bergmanson, J.P. (2019). Anatomy and physiology of the cornea and related structures. Contact Lenses, Elsevier.","DOI":"10.1016\/B978-0-7020-7168-3.00003-9"},{"key":"ref_14","first-page":"264","article-title":"Corneal angiogenic privilege: Angiogenic and antiangiogenic factors in corneal avascularity, vasculogenesis, and wound healing (an American Ophthalmological Society thesis)","volume":"104","author":"Azar","year":"2006","journal-title":"Trans. Am. Ophthalmol. Soc."},{"key":"ref_15","first-page":"13","article-title":"Focus: Sensory biology and pain: Corneal innervation and sensation: The eye and beyond","volume":"91","author":"Yang","year":"2018","journal-title":"Yale J. Biol. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Bukowiecki, A., Hos, D., Cursiefen, C., and Eming, S.A. (2017). Wound-healing studies in cornea and skin: Parallels, differences and opportunities. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18061257"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Gordon-Shaag, A., Millodot, M., Shneor, E., and Liu, Y. (2015). The genetic and environmental factors for keratoconus. BioMed Res. Int., 2015.","DOI":"10.1155\/2015\/795738"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/ceo.14113","article-title":"Infectious keratitis: A review","volume":"50","author":"Khoo","year":"2022","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.survophthal.2020.02.003","article-title":"Pathophysiology and management of glaucoma and ocular hypertension related to trauma","volume":"65","author":"Razeghinejad","year":"2020","journal-title":"Surv. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s40123-021-00383-w","article-title":"Ectasia after corneal refractive surgery: A systematic review","volume":"10","author":"Moshirfar","year":"2021","journal-title":"Ophthalmol. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.survophthal.2012.01.007","article-title":"Corneal neovascularization: An anti-VEGF therapy review","volume":"57","author":"Chang","year":"2012","journal-title":"Surv. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"25158414211020152","DOI":"10.1177\/25158414211020152","article-title":"Pterygium: An update on pathophysiology, clinical features, and management","volume":"13","author":"Shahraki","year":"2021","journal-title":"Ther. Adv. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S1001-9294(11)60038-2","article-title":"Time course of Q value after myopic laser-assisted in situ keratomileusis","volume":"26","author":"Zhang","year":"2011","journal-title":"Chin. Med. Sci. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1097\/OPX.0b013e31822717ca","article-title":"Corneal asphericity and its related factors in 1052 Chinese subjects","volume":"88","author":"Zhang","year":"2011","journal-title":"Optom. Vis. Sci."},{"key":"ref_25","first-page":"117","article-title":"Corneal shape and eccentricity in population","volume":"37","author":"Synek","year":"2013","journal-title":"Coll. Antropol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"39","DOI":"10.2174\/1874364102014010039","article-title":"Corneal indices determined with Pentacam in possible candidates for corneal refractive surgery","volume":"14","author":"Hidalgo","year":"2020","journal-title":"Open Ophthalmol. J."},{"key":"ref_27","first-page":"090041","article-title":"Corneal topography, an overview of its devices and systems\u2014A review","volume":"2787","author":"Ahmed","year":"2023","journal-title":"AIP Conf. Proc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.clae.2010.04.006","article-title":"Keratoconus: A review","volume":"33","author":"Wolffsohn","year":"2010","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1038\/s41572-020-0178-9","article-title":"Corneal dystrophies","volume":"6","author":"Soh","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Song, M., Chen, T., Moktar, A., Chan, E., Chong, E.W., Daniell, M., and Sahebjada, S. (2022). Diagnosis and Management of Keratoconus\u2014A Narrative Review of Clinicians\u2019 Perspectives. Children, 9.","DOI":"10.3390\/children9121973"},{"key":"ref_31","first-page":"1485","article-title":"Corneal degenerations","volume":"11","author":"Friedlaender","year":"1979","journal-title":"Ann. Ophthalmol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Roszkowska, A.M., and Wylegala, E. (2015). Corneal Degenerations. Oxidative Stress in Applied Basic Research and Clinical Practice, Humana Press.","DOI":"10.1007\/978-1-4939-1935-2_2"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1080\/17469899.2018.1555036","article-title":"Recent developments in keratoconus diagnosis","volume":"13","author":"Lopes","year":"2018","journal-title":"Expert Rev. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1136\/bjo.2008.147371","article-title":"Chasing the suspect: Keratoconus","volume":"93","author":"Klyce","year":"2009","journal-title":"Br. J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1007\/s00417-022-05916-y","article-title":"Biomechanical properties analysis of forme fruste keratoconus and subclinical keratoconus","volume":"261","author":"Huo","year":"2023","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5546","DOI":"10.1167\/iovs.10-5369","article-title":"Topographic and tomographic properties of forme fruste keratoconus corneas","volume":"51","author":"Saad","year":"2010","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1016\/j.jcrs.2013.03.023","article-title":"Posterior corneal elevation and back difference corneal elevation in diagnosing forme fruste keratoconus in the fellow eyes of unilateral keratoconus patients","volume":"39","author":"Muftuoglu","year":"2013","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1167\/iovs.04-1253","article-title":"Changes in collagen orientation and distribution in keratoconus corneas","volume":"46","author":"Meek","year":"2005","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40662-016-0036-8","article-title":"Corneal topography in keratoconus: State of the art","volume":"3","year":"2016","journal-title":"Eye Vis."},{"key":"ref_40","unstructured":"Song, J. (Review of Optometry, 2024). Sizing Up Keratoconus: The Roles of Topography and Tomography, Review of Optometry."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s40662-024-00386-1","article-title":"Multi-modal imaging for the detection of early keratoconus: A narrative review","volume":"11","author":"Sabbagh","year":"2024","journal-title":"Eye Vis."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Aumann, S., Donner, S., Fischer, J., and M\u00fcller, F. (2019). Optical coherence tomography (OCT): Principle and technical realization. High Resolution Imaging in Microscopy and Ophthalmology: New Frontiers in Biomedical Optics, Springer.","DOI":"10.1007\/978-3-030-16638-0_3"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s40662-020-00197-0","article-title":"The precision and agreement of corneal thickness and keratometry measurements with SS-OCT versus Scheimpflug imaging","volume":"9","author":"Zhao","year":"2020","journal-title":"Eye Vis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.2147\/OPTH.S251998","article-title":"Scheimpflug vs. scanning-slit corneal tomography: Comparison of corneal and anterior chamber tomography indices for repeatability and agreement in healthy eyes","volume":"14","author":"Kanellopoulos","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1080\/00207454.2020.1761353","article-title":"Evaluation of corneal sublayers thickness and corneal parameters in patients with Parkinson\u2019s disease","volume":"131","author":"Ulusoy","year":"2021","journal-title":"Int. J. Neurosci."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Bartz-Beielstein, T. (2024). Supervised Learning: Classification and Regression. Online Machine Learning: A Practical Guide with Examples in Python, Springer Nature.","DOI":"10.1007\/978-981-99-7007-0"},{"key":"ref_47","unstructured":"Mandell, D.B., and Stulting, R.M. (2024, November 18). A Practical Guide to the Interpretation of Corneal Topography. Contact Lens Spectrum. Available online: https:\/\/clspectrum.com\/issues\/1998\/march\/a-practical-guide-to-the-interpretation-of-corneal-topography\/."},{"key":"ref_48","unstructured":"Brownlee, J. (2016). K-Nearest Neighbors for Machine Learning, Machine Learning Mastery."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/11\/12\/1198\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:40:14Z","timestamp":1760114414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/11\/12\/1198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,27]]},"references-count":48,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["bioengineering11121198"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering11121198","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,27]]}}}