Keratoconus Treatment Options for Improved Vision and Comfort

Keratoconus (KC) is a degenerative condition that affects the cornea, which is a clear dome-like structure in the eye. The cornea of a person suffering from keratoconus thickens considerably and protrudes in a cone shape. Shape of the cornea causes distortion in vision and thus performing daily activities such as reading or driving, or even identifying people around becomes difficult. What may seem like a mild case to start with can result in serious impairment in vision over a period of time if proper precautions are not taken for keratoconus.

In this blog, we'll explore what keratoconus is, its causes, symptoms, and available treatment options.

What is Keratoconus?

The cornea is engaged in directing light rays on the retina and is important for a clear vision. A normal cornea, found in a healthy eye, is round and smooth. In contrast, people with keratoconus develop a cone-shaped cornea, because of the weakening and thinning of cornea which results in the bulging of cornea. This distortion of the cornea affects the entry of light rays into the eye hence causing distorted vision or difficulty in seeing clearly.

Keratoconus is mostly bilateral with marked unilateral involvement in most cases. It usually starts in the teenage between 10-25 years age group and remains in slow progression.

Causes of Keratoconus

The exact cause of keratoconus is not fully understood, but it is believed to be a combination of genetic, environmental, and biochemical factors. Some common factors affecting keratoconus include:

• Genetics: Research suggests that keratoconus can run in families, meaning if someone in your family has the condition, you may be at a higher risk of developing it.
• Eye Rubbing: Vigorous or chronic eye rubbing has been associated with the development and progression of keratoconus. Individuals with conditions like allergies or eczema, which often lead to frequent eye rubbing, are at greater risk.
• Collagen Deficiency: The cornea strength and shape are maintained by collagen fibres. In keratoconus, there may be a deficiency or weakening of these collagen fibres, causing the cornea to bulge.
• Oxidative Stress: Research indicates that oxidative damage to the cornea may contribute to the thinning and weakening of the tissue, making it more susceptible to keratoconus.

Symptoms of Keratoconus

The symptoms of keratoconus can vary from person to person. Some common symptoms include:

• Blurred or Distorted Vision: As the cornea becomes more cone shaped, vision becomes blurry and distorted. Straight lines may appear wavy, and objects may look out of focus.
• Increased Sensitivity to Light: Individuals with keratoconus often experience discomfort in bright lights, which can make it difficult to see in well lit environments or while driving at night.
• Frequent Prescription Changes: People with keratoconus may need frequent updates to their glasses or contact lens prescription as their vision continues to change.
• Double Vision or Ghost Images: Some individuals may see double or "ghost" images, even with corrective lenses.
• Eye Strain and Headaches: Straining to see clearly may result in headaches or eye discomfort.

Diagnosing Keratoconus

If you experience any of the symptoms explained above, it is important to schedule an eye exam with an ophthalmologist or optometrist. During the examination, the doctor may use various tests to diagnose keratoconus, including:

• Corneal Topography: This is the most common test used to diagnose keratoconus. It maps the shape of the cornea and can detect any irregularities or bulging.
• Pachymetry: This test measures the thickness of the cornea, which is important for identifying thinning in keratoconus patients.
• Slit Lamp Examination: During this test, the doctor uses a special microscope to examine the cornea for signs of keratoconus, such as thinning or scarring.

Treatment Options for Keratoconus

Treatment for keratoconus depends on the severity of the disease and how much it has progressed. Here are some common treatment options:

• Glasses and Soft Contact Lenses

In the early stages of keratoconus, vision can often be corrected with glasses or soft contact lenses. However, as the condition progresses and the cornea becomes more irregular, these options may no longer provide adequate vision correction.

• Rigid Gas Permeable (RGP) Contact Lenses

Rigid gas permeable (RGP) contact lenses are often prescribed when glasses or soft lenses are no longer effective. These lenses sit on top of the irregular cornea, providing a smooth surface to help improve vision.

• Scleral Contact Lenses

For individuals with more advanced keratoconus, scleral lenses may be recommended. These larger lenses vault over the entire cornea and rest on the white part of the eye (sclera), providing clear vision and greater comfort.

• Corneal Cross-Linking

Corneal cross-linking is a minimally invasive procedure that can help stop the progression of keratoconus. During the procedure, riboflavin (vitamin B2) drops are applied to the cornea, followed by exposure to ultraviolet (UV) light. This process strengthens the collagen fibres in the cornea, helping to prevent further thinning and bulging.

• Intacs

Intacs are small, semi-circular plastic inserts that are surgically placed into the cornea. These inserts help flatten the cornea and improve vision in people with mild to moderate keratoconus. Intacs can also make wearing contact lenses more comfortable.

• Corneal Transplant

In severe cases of keratoconus where other treatments are no longer effective, a corneal transplant may be required. During the transplant, the damaged cornea is replaced with a healthy donor cornea.

Living with Keratoconus

While living with keratoconus can be challenging, especially as it progresses, there are many effective treatments available to manage the condition. Early detection and treatment are key to preventing further vision loss. Regular eye check ups and following your doctor’s recommendations can help you maintain good eye health and quality of life.

Conclusion

Keratoconus is an eye condition that progresses over time and causes worsening of vision and effective functioning of an individual; however, with proper management and early intervention, a majority of patients with keratoconus. If you think you may have keratoconus, you shouldn’t waste time and should rather visit your healthcare provider because of the help that is most the treatment is the most appropriate for you.