What is Keratoconus?
Keratoconus is a progressive eye disorder that modifies the cornea's structure, the clear front surface of your eye. The condition causes the cornea to thin and slowly bulge outward into a cone-like shape, distorting its normal dome form. This shift can lead to blurred vision, light sensitivity, and glare as light is irregularly refracted. Typically, keratoconus manifests in both eyes and gradually evolves over time.
The Cornea is the clear window at the front of the eye which focuses light travelling through the eye onto the back of the eye (retina). In Keratoconus, the shape of the cornea is cone-shaped rather than being spherical. This results in the abnormal focusing of light as it travels through the eye leading to poor vision. Keratoconus is a disease which gets progressively worse with time, resulting in worsening vision.
What can be done to stop Keratoconus getting worse?
Cross Linking
Corneal collagen cross-linking is a treatment performed on the cornea to strengthen the fibers (collagen) that comprise it. Riboflavin (vitamin B2) drops are applied to the cornea and the cornea is exposed to ultraviolet light (UVA). This causes a chemical reaction which results in chemical bonds (cross links) to form between the collagen fibers in the cornea.
The result is that the cornea becomes stiffer and, as a result, the keratoconus is much less likely to worsen. There is very good evidence from large studies around the world that this is an effective treatment in stopping keratoconus progression.
How can vision be improved in Keratoconus?
The second stage of keratoconus treatment (once the progression has been stopped) is to improve the vision.
Spectacles
In mild cases of keratoconus, glasses can improve vision. Frequently, however, the quality of vision achieved with glasses is unsatisfactory.
Contact Lenses
Specialised contact lenses are required in keratoconus because soft contact lenses cannot correct for the abnormal cone shaped cornea. There are several types of contact lenses that can be used including, rigid gas permeable lenses, hybrid lenses and scleral lenses. These contact lenses can be fitted by a contact lens specialist with expertise is fitting these lenses in eyes with keratoconus. They provide a spherical surface over the cone shaped cornea which allows light to be focused in a normal manner. The vision achieved is usually excellent.
Laser Surgery
In some cases of keratoconus, laser can be applied to the cornea to improve its shape and improve its ability to focus light. This results in improved vision.
Corneal Transplant
In some severe cases of keratoconus, contact lenses may not be tolerated or may not provide satisfactory vision. In these cases, corneal transplantation becomes an option. The 2 types of corneal transplants performed for keratoconus are Deep Anterior Lamellar Keratoplasty (PK) and Penetrating Keratoplasty (PK). Find out more.
