Keratoconus

Understanding Keratoconus: Causes, Symptoms, and Treatments

Keratoconus is a vision disorder characterized by the thinning and cone-like deformation of the cornea, the eye's front surface. This irregular shape prevents light from focusing correctly on the retina, leading to distorted vision.

Causes and Risk Factors

1. Heredity: Approximately 10% of individuals with keratoconus have a close family member with the condition.

2. Frequent Eye Rubbing: Especially aggressive rubbing known as "knuckling" can contribute to keratoconus.

3. Medical History: Conditions such as asthma, allergies, Ehlers-Danlos syndrome, Down’s syndrome, and retinitis pigmentosa are associated with a higher risk of developing keratoconus.

Symptoms

Keratoconus typically begins with slight blurring and distortion of vision, along with increased sensitivity to glare and light. These symptoms often manifest in the late teens or early twenties. The condition may progress over 10-20 years before slowing. Each eye can be affected differently. As the disorder advances, the cornea bulges more, causing further vision distortion. In some cases, the cornea may swell due to a tiny crack, leading to a sudden and significant decrease in vision. This swelling can last for weeks or months as the crack heals and scar tissue forms. Eye drops can provide temporary relief if this occurs.

Diagnosis

Regular visits to an optometrist are crucial for measuring corneal curvature and detecting irregular astigmatism, aiding in the early diagnosis and monitoring of keratoconus.

Treatment Options

• Eyeglasses or Soft Contact Lenses: These can correct mild nearsightedness and astigmatism in the early stages of keratoconus.

• Corneal Cross-Linking Surgery: Recommended soon after diagnosis, this procedure helps stabilize the cornea's structure and slow the disorder's progression.

• Rigid Gas Permeable Contact Lenses: As keratoconus progresses, these lenses can provide adequate vision correction. They require careful fitting and regular checkups.

• Corneal Transplant: In severe cases, a corneal transplant may be necessary. Post-surgery, patients often still need glasses or contact lenses for vision correction.

• Intacs Intracorneal Inserts: These removable inserts can help stabilize astigmatism and nearsightedness.

• Implantable Collamer Lens Surgery: Once keratoconus progression stabilizes, this surgery can correct higher prescriptions, making glasses or conventional soft contact lenses more effective.

Conclusion

Early diagnosis and treatment are crucial in managing keratoconus effectively. Regular eye checkups, proper fitting of contact lenses, and timely surgical interventions can significantly improve the quality of vision for those affected by this condition.