Keratoconus

What is Keratoconus?

Keratoconus is a progressive thinning or ectasia of the cornea, which distorts the cornea, creating a cone-like bulge in this delicate tissue. As a result, the prescription of the eyes changes, blurring vision and causing irregular astigmatism. Keratoconus, by definition, means “cone-shaped cornea.” There is likely an inheritance pattern to this condition, which affects roughly 1:2000 individuals to varying degrees. It typically starts in the teenage years, progressing into the early thirties before achieving some sort of stability.

What are the symptoms of Keratoconus?

Keratoconus usually affects both eyes, though it may be asymmetric in presentation. Typical symptoms include:

1. Blurring of vision

2. Distortion of vision

3. Light sensitivity and glare

While the cause remains unknown, patients who suffer from allergies seem to be more prone to this condition. It is well known that eye rubbing can exacerbate this condition, therefore it is extremely important not to rub your eyes if you have keratoconus.

How is Keratoconus treated?

The good news is that the majority of people with keratoconus still enjoy good vision without the need for surgery. Treatment depends on the severity of the condition. In its early stages, eyeglasses are usually sufficient to obtain good vision. As the condition worsens, it may be necessary to switch to hard contact lenses in order to achieve acceptable vision.

When lenses are no longer helpful, surgery may be needed to help fit contact lenses. Keratoconus can be treated with Intacs, small, curved, implantable devices which help reshape and flatten the cornea.

More recently, another treatment option has become available: an in-office procedure known as collagen cross-linking. This procedure strengthens the cornea in order to slow down the progression of keratoconus. This treatment is particularly appropriate for individuals who display early signs of keratoconus with documented progression of the condition. Collagen cross-linking utilizes a vitamin solution coupled with a special UV light causing a chemical reaction which strengths the collagen beams that make up the cornea. This effectively ‘stiffens’ the cornea, preventing further bulging. This procedure typically takes about an hour.

When the above treatment options are no longer able to help achieve good vision, a corneal transplant is recommended. Typically 10% of patients with keratoconus require a corneal transplant.

While surgical options can help stabilize the progression of keratoconus, many people will still require the use of contact lenses.