Keratoconus: A New Study Indicates That It Is More Common and Concerning in the United States Than Previously Believed

Published on
June 27, 2023

At Amplify EyeCare, we continually strive to stay abreast of the latest developments in eye health. Today, we're focusing on keratoconus - a corneal disease that new research suggests may be as much as 10 times more common than previously thought, highlighting the importance of early detection and effective treatment.

The Changing Landscape of Keratoconus Prevalence

Until recently, keratoconus was believed to be a rare corneal disease, with the prevalence estimated as 1 in 2,000 individuals. However, a groundbreaking study published in Graefe's Archive for Clinical and Experimental Ophthalmology paints a different picture.

The Gutenberg Health Study: A New Perspective on Keratoconus

The Gutenberg Health Study (GHS), conducted in Germany from 2012 to 2017, undertook an extensive examination of over 12,000 Caucasian participants aged 40 to 80. The comprehensive exams included Scheimpflug imaging, an advanced diagnostic method that provides detailed information about the cornea's condition.

According to the Gutenberg Health Study, out of 10,419 participants, 51 participants (0.49%) were diagnosed with keratoconus. That suggests a keratoconus prevalence of about 1 in 200 in the Caucasian population, significantly higher than previously believed.

Age-specific Incidence and Prevalence of Keratoconus: A Nationwide Registration Study

An epidemiological study done using 4.4 million patients from the Netherlands estimated that the prevalence of keratoconus was 5 to 10 times higher than the previous estimates of 1 in every 2000 (1:2000) individuals. This study estimated that the prevalence of keratoconus in the general population is 1 in 375 (1:375)

What Percent of The US Population Has Keratoconus in 2023?

According to the United States Census Bureau, the Caucasian population in the United States in 2022 was approximately 75.5% of the total population, which was around 333 million. Therefore, the number of Caucasians in the United States was roughly 251 million. An estimated 49% of the population is over the age of 40, which comes out to 123 million caucasians over the age of 40 living in the US. 

Given the recent findings from the Gutenberg Health Study, with a prevalence of keratoconus now estimated to be 1 in 200 among Caucasians, it's now likely that over 650,000 Americans, within just the Caucasian population in the United States, could be affected by keratoconus.  

Adding to that number are those under the age of 40 and the approximately 25% of Americans over 40 that are not caucasian. Using the epidemiological study from the Netherlands, the estimate for the general population of the US would be 888,000 Americans with Keratoconus. 

While this might sound alarming, it's important to remember that knowledge is power. This new understanding of keratoconus prevalence underscores the importance of regular eye exams for early detection and treatment.

What About Other Risk Factors?

The Gutenberg Health Study (GHS) also explored potential risk factors for keratoconus, including age, sex, body mass index (BMI), thyroid hormone, smoking, diabetes, arterial hypertension, atopy, steroid use, sleep apnea, allergies, and asthma. Surprisingly, they found no significant associations. This further emphasizes the importance of regular eye check-ups for everyone, regardless of perceived risk.

Keratoconus Treatment: A Closer Look at Scleral Lenses

With keratoconus emerging as a more prevalent issue than we previously thought, the role of effective treatment methods is critical. One such solution that has demonstrated incredible results is the use of scleral lenses.

What Are Scleral Lenses?

Scleral lenses are specially designed contact lenses that differ from regular lenses in size and the area of the eye they cover. Unlike conventional lenses that rest on the cornea, scleral lenses extend over the entire corneal surface and rest on the "white" of the eye (the sclera). By doing so, they create a smooth, dome-shaped surface over the irregularly shaped cornea in a keratoconus patient.

How Do They Work?

Scleral lenses function by creating a tear-filled vault over the cornea. The lens doesn't actually touch the cornea itself, but instead, it rests on the sclera, leaving a clear, liquid interface between the back surface of the lens and the front surface of the cornea. This liquid layer effectively neutralizes the irregularities of the keratoconic cornea, leading to significantly improved vision and comfort.

The Benefits of Scleral Lenses

These lenses not only improve the visual acuity of keratoconus patients but also provide exceptional comfort, as they don't touch the sensitive corneal surface. This makes them a preferred choice for those who may have struggled with the comfort of traditional contact lenses. They also remain stable on the eye, without the risk of dislodging or causing discomfort from movement, making them a great option for those with active lifestyles.

Customized for Your Eyes

Each scleral lens is custom-designed for the individual patient based on the specific size and shape of their eye, ensuring a comfortable and effective fit. This customization process is performed by an experienced optometrist using advanced imaging technologies to capture highly detailed measurements of the entire ocular surface.

Long-term Management

Scleral lenses are an excellent long-term option for managing keratoconus. They help patients maintain clear, stable vision and continue their everyday activities without any significant restrictions. However, they do require careful fitting and regular follow-ups to monitor the health of the eye and ensure continued successful lens wear. Learn more about contact lenses for keratoconus here.

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