![]() |
Overview of Keratoconus
Keratoconus is a progressive eye disorder that affects the cornea, the clear, dome-shaped front surface of the eye. In individuals with keratoconus, the cornea gradually thins and bulges into a cone-like shape, leading to distorted vision. This condition can result in significant visual impairment and may require special corrective measures, such as rigid gas-permeable contact lenses or, in severe cases, surgical interventions.
Symptoms
- Blurred or Distorted Vision: Progressive thinning and bulging of the cornea lead to distorted or blurred vision.
- Increased Sensitivity to Light (Photophobia): The altered shape of the cornea may result in heightened sensitivity to light.
- Frequent Changes in Prescription Glasses or Contacts: Due to the changing corneal shape, individuals may experience frequent changes in prescription glasses or contact lenses.
- Astigmatism: Astigmatism becomes more pronounced as the cornea loses its regular shape.
Causes
- Genetic Factors: There is a genetic predisposition, and a family history of keratoconus may increase the risk.
- Biomechanical Changes: Weakening of the corneal tissue and alterations in its structural integrity contribute to the condition.
- Enzyme Abnormalities: Changes in the balance of enzymes responsible for maintaining corneal structure can lead to thinning.
What Happens Because of the Condition
- Corneal Thinning: Keratoconus causes progressive thinning of the cornea, leading to its conical shape.
- Corneal Bulging: The weakened cornea bulges outward, altering the refractive properties of the eye.
- Vision Distortion: Irregular corneal shape results in distorted vision, astigmatism, and myopia.
Risk Factors
- Family History: Having a family member with keratoconus increases the risk.
- Eye Rubbing: Constant and vigorous eye rubbing may contribute to the progression of keratoconus.
- Underlying Conditions: Conditions like atopic diseases (eczema, asthma) may be associated with keratoconus.
Diagnosis
- Corneal Topography: A non-invasive mapping of the cornea’s shape helps diagnose irregularities characteristic of keratoconus.
- Slit-Lamp Examination: A high-powered microscope (slit lamp) allows a detailed examination of the cornea’s structure.
- Refraction Test: Determines the extent of vision impairment and helps in prescribing corrective lenses.
Treatment Options
- Glasses or Contact Lenses: In the early stages, corrective lenses may be sufficient to address vision problems.
- Custom Contact Lenses: Specially designed contact lenses, such as rigid gas permeable or scleral lenses, can improve vision in more advanced cases.
- Corneal Cross-Linking: A procedure involving the application of ultraviolet light and riboflavin eye drops to strengthen the corneal collagen. Read more...
- Intacs: Implantation of small, semi-circular devices into the cornea to reshape and provide better structural support.
- Corneal Allogenic Intrastromal Rings (CAIRS): Surgical placement of rings made of tissue within the cornea to reshape its surface. Read more...
- Topographic-guided PRK Laser together with Corneal Cross-Linking. Read more...
- Corneal Transplant (Penetrating Keratoplasty or DALK): In severe cases, a corneal transplant may be considered.
- Phakic Intraocular Lens (IOL) Implantation: In certain cases, implanting a lens in addition to the natural lens inside the eye may be an option.
Complications
- Progressive Vision Loss: Without proper management, keratoconus can lead to progressive and significant vision impairment.
- Corneal Scarring: Advanced cases may result in corneal scarring, further contributing to visual distortion.
- Contact Lens Intolerance: As the cornea undergoes changes, individuals with keratoconus may develop intolerance to standard contact lenses.
Prevention
- Regular Eye Exams: Regular eye examinations, especially for individuals with a family history of keratoconus, can aid in early detection and intervention.
- Avoiding Eye Rubbing: Minimizing eye rubbing, particularly in individuals prone to atopic diseases, may help reduce the risk of keratoconus progression.
Medications
- Riboflavin (Vitamin B2) Eye Drops: Used in conjunction with ultraviolet light during corneal cross-linking to strengthen the corneal collagen.
- Prescription Eye Drops: In some cases, eye drops may be prescribed to address discomfort or manage associated conditions.
When to See a Doctor
- Vision Changes: Any sudden or significant changes in vision, especially blurriness or distortion, warrant immediate attention.
- Frequent Changes in Prescription: Individuals experiencing frequent changes in eyeglass or contact lens prescriptions should consult an eye care professional.
- Eye Discomfort or Pain: Persistent eye discomfort, pain, or light sensitivity should be promptly evaluated by a doctor.
Demographics More Susceptible
- Age and Genetics: Keratoconus often manifests in adolescence or early adulthood, and there is a genetic predisposition, making individuals with a family history more susceptible.
- Atopic Diseases: Those with atopic diseases like eczema or asthma may have a higher risk of developing keratoconus.
- Eye Rubbing: Constant and vigorous eye rubbing, often seen in individuals with allergies, may contribute to the progression of keratoconus.
Follow-up Care for Adults and Children
- Regular Monitoring: Individuals with keratoconus require regular monitoring by an eye care professional to assess progression and adjust treatment plans accordingly.
- Children: Paediatric Ophthalmologist: Children with keratoconus should receive ongoing care from a paediatric ophthalmologist. Educational Support: Providing educational support for children with visual impairment to ensure their academic success.
- Adults: Regular Eye Exams: Frequent eye examinations for adults to monitor changes in vision and corneal health. Adaptation to Treatment: Ensuring that adults are adapting well to prescribed treatments, such as contact lenses or post-surgical care.
Conclusion
Keratoconus demands vigilant monitoring and proactive management to address complications and preserve vision. Timely intervention, whether through corrective lenses, corneal cross-linking, or surgical procedures, plays a pivotal role in maintaining optimal eye health. Collaboration with eye care professionals and adherence to recommended follow-up care is essential for individuals with keratoconus to navigate potential complications and achieve the best possible visual outcomes.