Keratoconus

This is a condition where the cornea (the clear front part of the eye) has an abnormal, weaker shape, and as a consequence the vision deteriorates over time.

Symptoms

Keratoconus often affects both eyes and can cause a slow painless deterioration in vision.  Typically, it begins in the late teens to early 20’s and slowly gets worse over 10-20 years.  Symptoms can be different in each eye.  Initially one may experience mild blurring or distortion of vision.  There may be increased sensitivity to light and glare.  This can progress with symptoms of worsening vision and increased near sightedness or astigmatism.  If your optometrist keeps changing your glasses and your eyes are getting “weaker” quickly, it is a good idea to have an ophthalmologist review your eyes.

Causes

The underlying cause of keratoconus is not completely clear.  In some cases it appears to be genetic and is passed down in families.  Keratoconus has a strong association with eye allergies and eye rubbing so excessive eye rubbing should be avoided.

Risk factors

As noted, keratoconus has a strong association with ocular allergies.  If your eyes are very itchy, red and tearing and you rub your eyes a lot, one should see an ophthalmologist.  By adequate management of your allergies, one can prevent the eye rubbing that can change or worsen the shape of the front of the eye which can result in keratoconus.

Treatment

Keratoconus treatment depends on your symptoms and the extent of curvature change and thinning.  Early diagnosis and follow up by an ophthalmologist is important.  Both the stage of disease and rate of progression will be assessed and then managed appropriately based on this.  Your ophthalmologist will also manage any other associated conditions and symptoms, all which can help slow down the progression of keratoconus.

Early on, glasses are usually sufficient to compensate for this curvature change.  Later, hard contact lenses may be needed to maintain vision and focus.

Corneal collagen cross-linking can also be used.  Here, special ultraviolet light and eye drops are used together to strengthen and stiffen the cornea and slow down the progression of keratoconus.  Another treatment option are Intacs which are small curved devices that can be placed into your cornea.  These can help flatten the curvature of your cornea to improve vision.  In advanced cases one may need a corneal transplant to correct the condition.  Here, your ophthalmologist will replace all or part of your diseased cornea with healthy donor cornea tissue.

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