What Is Keratoconus?

What Is Keratoconus? Videos

A Layman’s Guide To Keratoconus

Keratoconus is a degenerative ocular disease where deterioration of the cornea causes thinning, brittleness, and a conical shape. As a result of this distortion in shape, light is unable to properly reach the retina, leading to impaired vision. In some cases, it leads to irregular astigmatism, as a result of two ocular curvatures.

Although there is no cure, there are several treatment options available, including various types of prescription contact lenses, a cross-linking procedure, surgical Intacs, and in severe cases, corneal transplant surgery.

Over the course of a patient’s life, some or all of these corrective measures may be implemented as the condition advances. Fortunately, with proper medical intervention, the risk of blindness is minimal. Nevertheless, as with all ocular disorders, appropriate care is critical to treat this condition and prevent deterioration. A comprehensive exam will enable the optometrist to make a diagnosis.

What Causes Progressive Keratoconus?

Although there is no definitive evidence of causation, studies strongly suggest that there may be a hereditary and genetic predisposition to this disorder:

Family history
There is evidence of comorbidity with Down’s syndrome, Ehlers-Danlos syndrome, hay fever, congenital amaurosis, and asthma
Aggressive eye-rubbing with the knuckles may be injurious.
Environmental factors such as climate may lead to eye-dryness and subsequent rubbing.

Signs of Keratoconus

As with many ocular disorders, signs present slowly and are hard to detect. Periodic comprehensive exams are critical for assessing vision changes, and monitoring and detecting progression of this ocular disease. Optometrists are able to identify indicators that go undetected by a layperson. The following signs may indicate the onset of this condition or other ocular disorder. Initial symptoms include:

distorted or blurry vision
sensitivity to bright light and glare.

One of the difficulties with this condition is that early signs can remain the same for years. During the earliest manifestation, interventions may include standard corrective lenses. Swelling is rare.

Later interventions include permeable contacts, options for collagen cross-linking procedures to prevent further alteration, Intac insertions, and in severe cases, a cornea transplant.

Diagnosing Keratoconus

Diagnosing a patient requires comprehensive testing using the following diagnostic tools:

Corneal-mapping: This procedure enables a 3D representation and eye mapping.
Slit-lamp: This device enables a comprehensive look at the internal ocular structures.
Refraction tests: These permit an assessment of visual strength.
Keratometry: A test to measure corneal shape using reflection from a special light.

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Treatments for Keratoconus

There are various options. As progression continues, treatment may include all or some of these options:

Contact lenses

Soft contacts: These standard lenses which provide increased comfort, may only be suitable for early cases of this disorder.
Hard contacts: As the disorder advances hard lenses are sometimes required. Although they may be uncomfortable, they provide impressive gains in vision.
Advanced options: Hybrid types lenses combine the comfort of a soft lens with gas permeability. “Piggy-back” types refer to the technique where a type of lens is placed over another one to blend the functions of the two.
Scleral lenses: When the condition advances and the corneal damage is severe, these are used to rest on the sclera, creating a new ocular surface.

Collagen cross-linking: In this procedure, measures are taken to prevent further alterations. It is accomplished with riboflavin eye-drops and ultraviolet light. 33.3350

Intacs: A procedure where semicircular plastic rings are inserted to strengthen the 80cornea and prevent further alteration.

Cornea transplant: In advanced cases where contacts and glasses are no longer effective, a transplant may be necessary to replace damaged tissue. Frequently, contacts or glasses will be necessary post-surgery. Scleral lenses act as a new ocular surface when scarring or damage is extant. While surgeries are usually successful, risks include possible (albeit unlikely) rejection of tissue and infections. Post-surgical maintenance will monitor and treat these conditions, should they present.

Find an Amplify Practice in Your Area

Amplify EyeCare is a team of a passionate and experienced optometrists practicing eye care at the cutting edge of technology and vision science. We are growing with new locations coming across the US.

Visit a Specialty Contacts vision clinic at an Amplify EyeCare practice near you:

Amplify EyeCare Santa Clarita in Santa Clarita, California
Amplify EyeCare Chattanooga in Hixson, Tennessee

Common Questions

At what age does keratoconus stop?

Keratoconus usually progresses for 10 to 20 years, typically slowing or stabilizing in the thirties or forties. Regular monitoring by a keratoconus specialist or optometrist is essential.

Does keratoconus stop after cross-linking?

Cross-linking is a procedure designed to halt or slow the progression of keratoconus. It strengthens the corneal fibers and often stabilizes the condition. While it may stop the worsening of keratoconus, it doesn't necessarily reverse existing damage. Regular follow-ups with a keratoconus specialist or optometrist are essential to monitor the condition post-procedure.

What type of contact lenses are best for keratoconus?

For patients with keratoconus, rigid gas permeable (RGP) lenses, custom soft lenses, or scleral lenses are often recommended by an eye doctor or keratoconus specialist. The choice depends on the severity and shape of the cornea. A comprehensive contact lens exam can help determine the best fit and type for an individual's unique needs.

Summary

Keratoconus is a degenerative, progressive, ocular disease where the cornea becomes thin, brittle, and cone-shaped, leading to distorted and blurred vision, and in some instances, irregular astigmatism. While there are no cures, there are effective interventions to treat the disorder and slow progression. With proper medical intervention, there is minimal risk of blindness.

Keratoconus management is critical because alterations in treatment plans will become necessary as the eye changes shape. Contact Amplify Eyecare today to find out more about this and other ocular disorders and to schedule a comprehensive exam if you haven't had one recently. With proper intervention, there are many options to slow down the progression of the disease and improve vision.