Keratoconus

Keratoconus is a progressive eye disease that often appears during teens or early twenties. Keratoconus is characterized by the thinning and eventually bulging of the round cornea into a cone-like shape.

This cone shape deflects light as it enters the eye on its way to the light-sensitive retina, causing distorted vision. Keratoconus can occur in one or both eyes.

Signs & Symptoms
Causes

Keratoconus can be difficult to detect as it develops rather slowly. As the cornea becomes more irregular in shape, progressive nearsightedness and irregular astigmatism start to develop, adding up to the distorted and blurred vision. It’s not unusual to have a delayed diagnosis of keratoconus especially if the practitioner is not familiar with the early-stage symptoms of the disease.

Symptoms:

Blurred vision, with regular early-stage changes in eyeglasses.
Light and glare sensitivity increased.

Factors of Risk:

Keratoconus typically occurs in one’s 20s and over time can worsen. Typically, it is bilateral, while unilateral cases appear to be worse. It is a progressive disease that, by the fourth decade of life, typically stabilizes.

The root cause of Keratoconus is still unknown but new research suggests that the weakening of the corneal tissue that leads to this may be due to an imbalance of enzymes within the cornea. This imbalance makes the cornea more susceptible to oxidative damage from compounds called free radicals, causing it to weaken and bulge forward. Risk factors for oxidative damage and weakening of the cornea include a genetic predisposition, explaining why Keratoconus often affects more than one member of the same family. Keratoconus is also associated with overexposure to ultraviolet rays from the sun, excessive eye rubbing, a history of poorly fit contact lenses and chronic eye irritation.

How Keratoconus Affects Vision

The Optometrist will detect the early stages of Keratoconus. In the very early phases, vision is also unaffected. It’s important to note that blindness is not caused by Keratoconus. Further changes in shape, thinning of the cornea and, in advanced stages, scarring, cause a loss of transparency of the cornea if left unchecked, which impairs the eye’s ability to properly concentrate. However, also in advanced keratoconus, vision correction with contact lenses is generally possible.

Treatment

In the mildest form of Keratoconus, eyeglasses or soft contact lenses may help. But as the disease progresses and the cornea thins and becomes increasingly more irregular in shape, glasses or soft contacts no longer provide adequate vision correction. The Pentacam, a rotating Scheimpflug camera which captures Scheimpflug images of the anterior eye segment is commonly used for early diagnosis of Keratoconus. A corneal transplant may be needed in very advanced cases, where contact lenses fail to improve vision. However, since the advent of corneal cross-linking, this form of intervention has been unusual (CXL). A relatively new therapy that can avoid the disease from getting worse is CXL. With a single 30-minute outpatient procedure, it is successful in over 94 percent of patients.

Corneal Cross Linking

Another new procedure for treating Keratoconus, known by the brand name of C3-R (Corneal Collagen Cross-linking with Riboflavin), is a non-invasive method of strengthening corneal tissue to prevent bulging of the eye’s surface.

In the C3-R procedure, eye drops containing riboflavin (vitamin B2) are placed on the cornea and are then activated by ultraviolet (UV) light to strengthen links between the connective tissue (collagen) fibers within the cornea.

Collagen cross linking is not a definitive cure for Keratoconus, but rather a preventive method to arrest its progression.

Corneal Transplant

This is considered to be the last remedy for Keratoconus for more advanced cases where contact lenses or other therapies no longer provide acceptable vision. Corneal transplant is also called a Penetrating Keratoplasty (PK or PKP).

EBSAAR Offers a New Module in the Treatment of Keratoconus

The new module in the treatment of Keratoconus consists of a combination of two new and effective procedures. The irregular shape of the cornea in keratoconus that causes image deformation can be modified by means of Topography Guided Laser Photorefractive Keratectomy (T-CAT PRK). This is the first step of treatment and this amazing technique will improve the quality of vision and eventually the visual acuity that can free the patient of glasses and other visual aids.

Along with T-CAT PRK, we will perform collagen cross linking procedure to increase the stiffness of the cornea, stabilize it and stop its bulging. The simultaneous T-CAT PRK with CXL will provide the following:

Correct the irregular shape of the cornea
Improve the quality of vision
Improve the visual acuity
Stabilize the cornea and protect the patient from the need of Keratoplasty.

What Happens if You Experience Keratoconus?

Keratoconus does not require immediate referral, as it typically takes several months or even years for changes induced by the condition to occur. Because of this, for up to five years after their initial visit, we track those with the condition and bring them back for repeat evaluations.

Several of the same tests will be conducted each time you visit a clinic, including:

Vision for (reading chart)
Refractionation (spectacle test)
Scans for corneal (including Pentacam)

CXL is only necessary if there is a continuing deterioration of the corneal shape. At your appointments, this will be detected. However, if the cornea is too thin, it may be dangerous to conduct the procedure after a certain level. The cornea typically stiffens naturally in individuals in their late 30s, and CXL is usually not needed. The cornea is more versatile below this age, and disease progression (and deteriorating vision) is more likely to occur, but not definite.

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FAQ’s

Frequently Asked Questions (FAQ)

If you still have questions about LASIK treatment, have a look at out FAQ or give us a call and schedule a consultation with an expert!

Can Keratoconus affect the equilibrium of a person?

Balance relies on input from the inner ear, the visual system and the neurological system. Different lenses will affect your balance in the keratoconus, so consult your doctor to fix the problem. Since balance issues may have other triggers, speak to your doctor about this primarily if it worsens.

How do you clarify uural cases if the Keratoconus is bilateral?

The other may have developed an acute, but nearly undetectable, keratoconus. It can display or stay that way with symptoms.

Is it common for different lenses to be worn in each eye?

The doctors independently measure each eye, then prescribe the lenses accordingly. You’d better speak with your doctor about this problem.

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