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Author Ibrahim Moshood

Keratoconus

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Keratoconus

Keratoconus

Keratoconus is a condition that affects the cornea; the clear, dome-shaped front surface of the eye. This condition is characterised by the thinning out of the cornea which gradually bulges outward and forms into a cone shape. A cone-shaped cornea cause vision to be blurry and may lead to sensitivity to light and glare. Although […]

Symptoms

There are a couple of keratoconus symptoms. However, they are susceptible to changes as the disease progresses. Keratoconus symptoms include

  • Blurry or distorted vision.
  • Sensitivity to bright lights and glare occurs. This can make night driving difficult..
  • Frequent changes of eyeglass prescriptions.
  • Unexpected worsening or clouding of vision
  • Progressive near-sightedness and irregular astigmatism may develop as the cornea becomes more irregular in shape. 
  • Difficulty in seeing at night.
  • Eye irritation and headaches associated with eye pain.
  • Double vision when looking with just one eye, and triple ghost images

Causes

The exact cause of keratoconus is unknown. Although genetic and environmental factors are thought to play a role, as around 1 in 10 people with a keratoconus have at least a parent with the condition. Researchers also think, from researches, that some people are more likely to get it from birth.

Researches also suggest that the weakening of the corneal tissue that leads to keratoconus may be as a result of an imbalance of the collagen enzymes within the cornea. This imbalance makes the cornea more prone to oxidative damage by free radicals, thereby causing it to weaken and bulge forward.

This oxidative damage and weakening of the cornea may be due to a genetic predisposition, explaining why keratoconus often affects more than one member of the same family.

It has also been established that keratoconus is associated with excessive eye rubbing, overexposure to ultraviolet rays from the sun, a history of poorly fitted contact lenses and chronic eye irritation.

More about Treatment

Keratoconus is a condition that affects the cornea; the clear, dome-shaped front surface of the eye. This condition is characterised by the thinning out of the cornea which gradually bulges outward and forms into a cone shape. A cone-shaped cornea cause vision to be blurry and may lead to sensitivity to light and glare. Although keratoconus affects both eyes. It, however, often affects one eye more than the other. The onset begins between the ages of 10 and 25, and slowly progress for 10 years or longer. During the early stages of keratoconus, vision problems might be able to be corrected with glasses or soft contact lenses. In the later stages of keratoconus, it requires being fitted with rigid, gas permeable contact lenses, or other types of lenses, like scleral lenses. For advanced stages of keratoconus, a cornea transplant may be needed. However, a new treatment known as corneal collagen cross-linking may help to slow or stop keratoconus from progressing, and possibly preventing the necessity for a future cornea transplant. This treatment might be offered along with the vision correction options mentioned above. Diagnosis  The steps taken in the diagnosis of keratoconus include 

  • Medical and family history review, and 
  • Conduction of an eye exam. 
Other tests may also be conducted to acquire more details regarding the shape of your cornea. These include:
  • Eye refraction: For this keratoconus test, special equipment is used to measure the eyes to check for vision problems. The patient will be asked to look through a device that contains wheels of different lenses, to help ascertain which combination gives you the sharpest vision. This may also be done through the use of a hand-held instrument to evaluate your eyes.
  • Slit-lamp examination: For this keratoconus test, a vertical beam of light is directed on the surface of the eye and a low-powered microscope is used to view the eye. This helps to evaluate the shape of your cornea and also looks for other potential eye problems.
  • Keratometry: For this keratoconus test, a circle of light is focused on your cornea to measure the reflection, to ascertain the basic shape of your cornea. A value ≥ 47.2 Diopters is suggestive of keratoconus.
  • Computerized corneal mapping: For this keratoconus test, special photographic tests, such as corneal tomography and corneal topography, are carried out to record images and create a detailed shape-map of the cornea. While corneal tomography measures the thickness of your cornea, corneal tomography detects early signs of keratoconus before it becomes visible by slit-lamp examination.
  • Ultrasonic Pachymetry: This keratoconus test is used to confirm and measure thinning in the cornea.
Keratoconus Treatment  There are three methods of keratoconus treatment, and the choice of keratoconus treatment depends on the severity of the condition and how quickly it is progressing. These are –
  • Slowing the progression of the disease,
  • Improving your vision, and
  • Corneal transplant.
  1. Slowing the progression of the disease
In progressing keratoconus, the first option considered is to slow or stop the progression. This is done through a technique known as corneal collagen cross-linking. This technique, although newer, has proven to have the potential to prevent a future cornea transplant. It should, however, noted that this treatment does not reverse keratoconus or improve vision.       2. Improving your vision This keratoconus treatment option depends on the degree of severity, and it’s usually opted for in mild to moderate keratoconus.  This involves keratoconus treatment with eyeglasses or contact lenses. This is a, likely, long-term treatment, especially if the cornea becomes stable with time or from cross-linking.      3. Corneal transplant In some people or at an advanced stage of keratoconus, either the cornea becomes scarred with advanced disease, or wearing contact lenses becomes difficult. In this instance, the choice of keratoconus treatment will most likely be a cornea transplant surgery.

FAQ

  • What is keratoconus?

Keratoconus is a condition that occurs when the cornea thins out and protrudes like a cone. The change in the shape of the cornea takes light rays out of focus. Thus causing vision to be blurry and distorted, and making daily tasks such as reading or driving difficult.

  • When should I see a doctor?

You should see an eye doctor (an ophthalmologist or an optometrist) when your eyesight begins to rapidly worsen. Although, this might be caused by an irregular curvature of the eye (known as astigmatism). The doctor may also check for signs of keratoconus during routine eye exams.

  • What are the risk factors for keratoconus?

The following mentioned factors have been found to predispose people to keratoconus

  1. A family history of keratoconus.
  2. An atopic disorder.
  3. Vigorous rubbing the eye.
  4. Lax eyelids
  5. Some connective tissue disorders (such as, Ehlers-Danlos syndrome, Marfan syndrome, osteogenesis imperfecta)
  6. History of Down syndrome, hay fever, asthma and retinitis pigmentosa
  7. Certain congenital disorders with poor vision (such as, Leber congenital optic neuropathy, and retinopathy of prematurity).
  8. Obstructive sleep apnea.
  9. Race: A study carried out on keratoconus discovered that Blacks or Latinos are approximately 50% more likely to suffer keratoconus than whites. 
  • Are there any complications with keratoconus?

A couple of complications may arise

  1. Cornea swelling leads to a sudden reduction in the quality of vision and scarring of the cornea.
  2. In advanced stages of keratoconus, the cornea may become scarred, particularly when the cone is prominent. A scarred cornea worsens vision problems and may require cornea transplant surgery.
  • Will I need surgery for keratoconus?

Most times keratoconus treatment does not require a cornea transplant. The use of a contact lens or glasses is enough to treat and correct visions. 

However, in circumstances where vision can no longer be corrected with the use of glasses or contact lenses, surgery may be recommended. 

  • What are the stages of keratoconus?

There are two stages of keratoconus – latent stage (recognisable by a placido disc only) and early stage

The early stages were subdivided into two categories as:

  1. Keratoconus fruste, which entails 1 to 4 degree deviation of the horizontal axis of the placido disc.
  2. Early or mild keratoconus, which entails 5 to 8 degree deviation of the horizontal axis.
  • How can I prevent keratoconus?

Quite unfortunate, keratoconus cannot be prevented, or should I say there’s no known way to prevent its occurrence. It is, however, advised one should avoid rubbing the eyes.

Top Doctors For Keratoconus Treatment

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    483

Dr. C. Arvind Babu Opthalmology | Gender: Male | Experience: 3 years | Hospital: Sri Ramachandra Medical Centre (SRMC)
Dr. Radha Annamalai Opthalmology | Gender: Female | Experience: 34 years | Hospital: Sri Ramachandra Medical Centre (SRMC)
Dr. Mary Thomas Opthalmology | Gender: Female | Experience: 24 years | Hospital: Sri Ramachandra Medical Centre (SRMC)
Dr. Mridula Mehta Opthalmology | Gender: Female | Experience: 18 years | Hospital: Primus Super Speciality Hospital, Delhi
Dr. Faruk Eroğlu Opthalmology | Gender: Male | Experience: 26 years | Hospital: Hisar Intercontinental
Prof. Dr. Ömer Kamil Doğan Opthalmology | Gender: Male | Experience: 25 years | Hospital: Hisar Intercontinental
Dr. Tarun Kapur Opthalmology | Gender: Male | Experience: 29 years | Hospital: Max Super Speciality Hospital, Saket
Dr. Sanjay Dhawan Opthalmology | Gender: Male | Experience: 25 years | Hospital: Max Super Speciality Hospital, Saket
Dr. Poornima Shadaksharappa Opthalmology | Gender: Female | Experience: 10 years | Hospital: Thumbay Hospital, Ajman
Dr. Soman Sukumaran Nair Opthalmology | Gender: Male | Experience: 10 years | Hospital: Thumbay Hospital, Dubai
Dr. Mohit Jain Opthalmology | Gender: Male | Experience: 13 years | Hospital: RAK Hospital
Dr. Archana Sood Opthalmology | Gender: Female | Experience: 15 years | Hospital: RAK Hospital
Dr. Mohamed Ahmed Wassfi Opthalmology | Gender: Male | Experience: 15 years | Hospital: Saudi German Hospital
Dr. Essam El Toukhy Opthalmology | Gender: Male | Experience: 20 years | Hospital: Saudi German Hospital
Dr. Abdul Aziz Badla Opthalmology | Gender: Male | Experience: 25 years | Hospital: Saudi German Hospital
Dr. Daryoush Ahmadiazad Opthalmology | Gender: Male | Experience: 10 years | Hospital: Saudi German Hospital
Dr. Mohammad Hadi Opthalmology | Gender: Male | Experience: 22 years | Hospital: Saudi German Hospital
Dr. Anuradha Rao Opthalmology | Gender: Female | Experience: 32 years | Hospital: Kokilaben Dhirubhai Ambani Hospital

Top Hospitals For Keratoconus Treatment

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Thumbay Hospital, Dubai With our Hospitals and Medical Centre in Ajman, Fujairah, Sharjah, Dubai and Hyderabad (India), Thum
Maharaja Agrasen Hospital, Bengaluru The Maharaja Agrasen Hospital is located in the heart of Bangalore and is known of its excellence in
Columbia Asia Hospital, Bengaluru Columbia Asia is an international healthcare group operating a chain of modern hospitals across Indi
Gleaneagles Global Hospital, Mumbai Gleneagles Global Hospital, Mumbai offers end-to-end clinical, surgical and diagnostic services. The
Peerless Hospital, Kolkata 400 bed Multi-Specialty Peerless Hospital & B.K.Roy Research Centre is build around the core princip
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