Keratoconus is a degenerative eye disorder affecting the shape of the cornea, the clear structure covering of the front of the eye (similar to the glass faceplate on a watch). Over time, in Keratoconus, the normally round cornea begins to bulge into a cone-like shape, deflecting light entering the eye and causing distorted vision.
The cause of Keratoconus is currently unknown, although several researchers believe allergies and excessively rubbing one’s eyes may play a role.
Signs and Symptoms of Keratoconus
- The cornea becomes more irregular in shape
- Subtle blurring of the vision
- Causes progressive nearsightedness and irregular astigmatism
- Glare and light sensitivity may occur
- Frequent changes in eyeglass prescription
If you are experiencing the above symptoms, schedule an appointment with your eye doctor as soon as possible. Any sudden change in your vision is a serious medical condition that requires prompt medical attention from your optometrist or ophthalmologist.
The primary treatment option for Keratoconus patients remains the use of contact lenses, including:
- Custom soft contact lenses specially designed to correct mild-to-moderate forms of this eye disease.
- Rigid gas permeable (RGP or GP) contact lenses, which, with their rigid shape, replace the irregular shape of the cornea with a smooth refracting surface.
- Some eye care professionals recommend “piggybacking” two different types of contact lenses on the same eye to increase the wearer’s comfort.
Other Keratoconus treatment options include:
- Collagen cross-linking, which is still in clinical trials, is a technique that uses UV light and a photosensitizer to strengthen chemical bonds in the cornea to halt progressive and irregular changes in corneal shape.
- Severe cases of Keratoconus may require corneal transplantation. Still, even after a transplant, you will likely need glasses or contact lenses for clear vision.
Your eye doctor will be able to better inform you of your treatment options.
More on Corneal Collagen Crosslinking: The Methods
Collagen crosslinking, an investigational treatment in the United States, was first performed in Europe in the late 1990s for the treatment of ectatic corneal conditions. The treatment combines riboflavin and ultraviolet A (UVA) light, allowing the formation of reactive oxygen species, with the goal of halting the progression of corneal disease.[1-4]
For riboflavin to act as a catalyst in this process, it must first be absorbed into the corneal stroma. Because the corneal epithelium acts as a barrier to riboflavin absorption, it can be removed before treatment with UV light.
The Dresden technique, or “epi-off” crosslinking, is initial removal of the central 9 mm of epithelium, followed by 30 minutes of riboflavin administration. Subsequently, UVA light is applied for 30 minutes, followed by bandage contact lens placement. Epi-off crosslinking can be effective in reducing keratometry readings.[1,3-5] The potential risks of this procedure include initial worsening of vision in the first month, pain, haze, corneal melt, and infection.
Dr. Brian Boxer Wachler was the first to perform transepithelial crosslinking, or “epi-on” crosslinking, in 2004. Because the epithelium is not removed, riboflavin loading requires more time than with epi-off techniques. Epi-on crosslinking has several distinct advantages: faster visual recovery; reduced pain; and reduced risks for delayed epithelial healing, infection, and visually significant corneal haze.
To learn more about Keratoconus and proper eye health, please contact board certified ophthalmologist Dr. Samuel Boles, consultative optometrist Dr. Nathan Frank, and the eye care specialists at Anne Arundel Eye Center by calling 410-224-2010 or click here to visit AnneArundelEyeCenter.com.
Located in Annapolis, Maryland, the Anne Arundel Eye Center offers comprehensive specialized ophthalmic exams as well as diagnostic pre and post-surgical eye care. Specializing in glaucoma and cataracts, Dr. Boles has helped restore and preserve thousands of patients’ vision.
Presbyopia, Glaucoma, and Cataracts may be a common part of aging. Losing your vision doesn’t have to be.
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Nathan Johnson says
Thanks for explaining what keratoconus is and what the common treatments are. My brother was recently told that he has this and he is looking around to find the best treatment for him. The most curious thing about keratoconus is that we don’t know exactly what causes it. It is good that there are relatively effective treatment options, though. Thanks for sharing!