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The cornea is the clear, dome-like surface that is located in front of the eye. When this cornea becomes too thin and eventually protrudes outward into a cone-like structure. This cone-shaped cornea leads to blurry vision and can make the person extremely sensitive to light and glare. The condition often occurs in both eyes, but one is often more affected than the other.

Keratoconus tends to affect people mostly between the ages of 10 and 25 years and continues to worsen for another 10 years or probably longer. In the initial stages, the problem can be corrected with prescriptive glasses or soft contact lenses. In the later stages, the patient might need to be fixed with rigid, gas, porous contact lenses. In cases, where the condition advances to severe stages, the patient might need a cornea transplant.

Symptoms of Keratoconus

Signs and symptoms of this condition change with the advancement of the problem. Some of the common symptoms include:

  • Blurred or distorted vision
  • Intense sensitivity to bright light and glare
  • Problem with night driving
  • Consistently and frequently changing eye power
  • Sudden worsening of vision
  • Cloudy vision

For patients who experience rapidly worsening eye vision, immediate medical attention must be sought.

Causes of Keratoconus

There are no defined reasons for keratoconus. However, the problem can occur because of genetic and environmental factors, including hereditary conditions.

That said, some factors that increase the risk of keratoconus, include:

  • A family history of keratoconus
  • Vigorous rubbing of eyes
  • Some eye conditions, such as retinitis pigmentosa, hay fever, asthma, etc.

Complications of Keratoconus

In some cases, the cornea can become swollen too rapidly and cause sudden loss of vision and scarring of the cornea. This problem can break down the lining of the cornea, which allows the fluid to enter the cornea. The swelling goes off on its own but can lead to the formation of a scar that can hamper vision.

Moreover, advanced keratoconus can also cause the cornea to become scarred, especially in the area where the cone is most prominent. A scarred cornea can lead to severing vision issues that might need to be treated by a cornea transplant surgery.

Diagnosis of Keratoconus

To diagnose the condition, the optometrist or an ophthalmologist, will conduct an assessment of the medical history of the patient, and understand the symptoms. The doctor will also understand the family history and then conduct some tests to better understand the shape of the cornea. Some of the tests that can be used for this purpose include:

  • Eye refraction, where a special piece of equipment is used to measure the eyes to identify vision problems.
  • Slit-lamp exam, where the doctor directs a vertical beam into the patient’s eye surface and then uses a microscope (low-powered) to see the eye more clearly.
  • Keratometry, in this test the doctor leads a circle of light on the cornea and assess the reflection to understand the shape of the cornea.
  • Computerized corneal mapping, including corneal tomography and corneal topography, can be used to provide images to understand the shape of the cornea in deeper detail. This can help identify the keratoconus even before the disease shows any visible signs or is detected via other exams.

Treatment of Keratoconus

There is no one fixed treatment for this condition. The treatment depends on case-to-case and mostly varies per the severity of the problem and how quickly is the condition progressing. Typically, keratoconus can be treated in two ways – either by slowing the issue or by enhancing the vision.

If the condition is worsening, a new form of treatment that is called corneal collagen cross-linking can be used to treat the patient. This form of treatment has the power to minimize symptoms and reduce the chances of a cornea transplant. However, this form of treatment does not improvise vision or reverse the condition.

On the other hand, the severity of keratoconus affects the chances of vision treatment. Patient with a mild or moderate issue can be treated with the help of prescriptive eyeglasses or contact lenses. However, the treatment will take a long time before it starts to show improvement.

That said, in patients with extreme keratoconus the cornea can be too damaged and become scarred. Even wearing contact lenses for a prolonged period can cause damage to the cornea. In such cases, a cornea transplant surgery may be required.

Some lenses which can be used to treat keratoconus include:

  • Eyeglasses or soft contact lenses
  • Hard contact lenses
  • Piggyback lenses
  • Hybrid lenses
  • Scleral lenses

Overall, keratoconus can be very discomforting but with timely and preventive eye check-ups, precautions, and advice from the healthcare professional, the condition can be prevented. Moreover, it can also help to detect the condition at an early stage and avoid serious complications that might occur later.

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