Keratoconus Facts and Treatment
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Keratoconus Facts and Treatment

Keratoconus is a rare degenerative disorder of the eye causing gradual corneal dystrophy. This article discusses the causes, symptoms, and treatment procedures for Keratoconus.

Keratoconus is a very rare degenerative eye disorder causing progressive thinning of the cornea of the eye. It causes the cornea to become cone-shaped, thus deteriorating vision. It is the most common form of corneal dystrophy observed in the United States and is believed to be affecting one in every 2000 Americans. However, Keratoconus does not cause complete blindness. It causes significant distortion of vision. Most patients report seeing multiple images and complain of sensitivity towards light. Typically, Keratoconus is diagnosed in the patient's adolescent years and is known to be at its most severe form in the late twenties and thirties. Despite being unpredictable, Keratoconus can mostly be taken care of and rarely impairs the patient’s quality of life.

The exact cause of Keratoconus is still unknown. Certain studies associate Keratoconus with harmful enzyme activity within the cornea. Few studies hold environmental and genetic factors responsible for the corneal dystrophy. However, none of the theories are conclusive enough to establish the exact cause. The progression of Keratoconus has been observed to be rapid in patients having Down syndrome, allergies or congenital amaurosis (a rare form of blindness at birth). Also, it often develops in long time contact lens users due to forceful rubbing of the eyes.

Early symptoms of Keratoconus include decreased vision and progressively worsening nearsightedness. Usually Keratoconus is accidentally discovered when a patient visits an ophthalmologist because of decreased vision.

Most often Keratoconus can be treated by using corrective lenses or glasses. If it is in early stages and there is only mild distortion of the cornea, contact lenses can be used to restore proper vision. The contact lenses used by Keratoconus patients are usually of the hard or rigid gas-permeable variety. However, soft or hydrophilic lenses and silicone hydrogel lenses are gaining popularity these days. Contact lenses give the cornea a smoother surface, thus allowing the patient to see clearly. However, if the cornea is severely scarred or damaged, it is ideal to opt for corneal transplant. A corneal transplant surgery replaces the diseased cornea with a healthy cornea from a deceased donor. Most Keratoconus patients see very clearly after the corneal transplant surgery.

Proper treatment (contact lenses, corneal transplant, refractive surgery procedures et cetera) establishes better and improved vision in most Keratoconus patients. The modern treatment techniques are very effective and have high success rates.

 

Symptoms

The earliest symptom observed in patients with Keratoconus is slight blurring of vision, which cannot be corrected with glasses. Most Keratoconus patients develop progressively worsening nearsightedness.

The major symptoms indicating Keratoconus are:

  • Blurred and distorted vision
  • Sensitivity towards Light
  • Nearsightedness or Myopia
  • Astigmatism

 

Diagnosis

Keratoconus is usually diagnosed during adolescence. A slit-lamp examination of the cornea helps identify the occurrence. A Corneal Topography test creates a map of the curve of the cornea. This is considered as the most accurate test for Keratoconus diagnosis. In the advanced stages of Keratoconus, the cornea is thinnest at the point of the cone. This is diagnosed with a test called Pachymetry.

 

Treatments

  • Eyeglasses – Early stages of Keratoconus can be treated with corrective glasses.
  • Contact Lenses – Rigid gas-permeable lenses, Hydrophilic lenses and Silicone Hydrogel lenses prove to be effective in cases of mild corneal distortion.
  • Corneal transplant – Badly damaged corneas need to be surgically replaced. Corneal transplants in case of Keratoconus patients are highly effective with a success rate of more than 90%.
  • Corneal Ring Segment Inserts – Involves the insertion of intrastromal corneal ring segments in the patient’s cornea. This is used as an alternative to corneal transplant.
  • Epikeratophakia – Is a refractive surgical procedure. The donor’s corneal tissue is grafted into the recipient’s cornea.
  • Radial Keratotomy – Is a refractive surgical procedure. Tiny incisions are made in the patient’s cornea, thus flattening it and modifying its shape.
  • DALK transplants (Deep Anterior Lamellar Keratoplasty) – The chances of graft rejection is greatly reduced in the DALK transplants. The patient’s cornea is dissected to almost 95% leaving only the endothelial layer, and replaced with the donor tissue.

 

Complications

Corneal transplantation procedures bear a risk of rejection. However, the risk involved is considerably lower than other organ transplants. Patients in the early stages of Keratoconus should not opt for laser vision correction.

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