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What is Keratoconus?

Keratoconus is a condition of the eye in which the structure of the cornea (the clear outer part of the eye) is not strong enough to hold its round shape, causing it to bulge outwards like a cone. This corneal bulging process can happen and progress very quickly or over years, but these changes can stop progressing at any time. Leading to visual distortion with a high degree of astigmatism (corneal irregularity).

Structure of a normal cornea and a cornea with Keratoconus

What causes Keratoconus?

Keratoconus often starts when people are in their early to late 20s. Visual symptoms slowly get worse over a period of time, that maybe a couple years to a much longer time frame. We do not know why people develop Keratoconus. Often, this condition is hereditary, it is estimated 1 out of 8 people with Keratoconus has a parent who has it too.

Other causes to Keratoconus include trauma to the cornea, excessive eye rubbing, chronic ocular irritation, poorly fitted contact lenses.

Keratoconus Symptoms

  • Sudden change of vision in just one eye
  • Double vision
  • Bright lights with halos around them
  • Light streaking
  • Seeing ghost images

What is the Treatment for Keratoconus?

Keratoconus treatment depends on your symptoms and vision. When your symptoms are mild, your vision can usually be corrected with eyeglasses and soft contact lenses. Eventually eyeglasses and soft contact lenses are no longer sufficient and other options are available and are generally attempted in the following order:

Gas permeable contact lenses/Hybrid contact lenses/Scleral contact lenses: These lenses are used due to their rigidity, which improves vision by changing the irregular cone shape into a smooth surface. Initially patients find these lenses difficult to put in and take out, and maybe uncomfortable to adjust to. But usually with one to two weeks most people adjust.

Corneal cross-linking treatmentCorneal cross-linking: Corneal Cross-linking (also known as CXL) involves strengthening the corneal tissue to halt the bulging of the eye’s surface. First introduced into the United States in 2008, the procedures involved placing drops of Riboflavin (Vitamin B) on the cornea followed by UV light exposure helping to stiffen and in some instances reverse the bulging surface. The procedure obtained FDA approval in 2016. As is quickly becoming the treatment of choice by many doctors.

Corneal inserts or Intacs treatmentCorneal inserts or Intacs: Tiny plastic arc inserts are placed in the middle of the cornea in order to reshape it.

Corneal transplantCorneal transplant: Penetrating Keratoplasty (also known as PK or PKP) is the treatment of choice when all other non-surgical and surgical options have been exhausted. The procedure involves removing the bulging cornea and replacing it with a healthy cornea from a donor. The transplanted cornea is held in place by sutures attaching the donor to one’s own tissue. Many follow-up visits are necessary at which time the sutures are slowly removed. With all that said, corneal transplants are by far the most success transplants in medicine.

Are Allergies and Keratoconus related?

There correlation between allergies and Keratoconus is well documented. Nonetheless, not every single person who has allergies develops Keratoconus but a percentage of patients who have Keratoconus do have allergies. As such it’s important not to rub your eyes. Rubbing can damage the thin bulging corneal tissue and make your symptoms worse. And if you do have allergies or itchy eyes, speak to your eye doctor about starting allergy eye drops.

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