Dr. Aditi Manudhane

Keratoconus is a progressive vision disorder which occurs when the normally round cornea becomes thin and cone-shaped, and bulges out, deflecting the light entering the eye leading to a distorted and blurry vision.

Causes of Keratoconus:

Weakening of the collagenous fibre, which holds the cornea in its regular place, leads to its bulging out. Decreased levels of antioxidants in the cornea too cause the condition by damaging the fibre from external pollutants. It is also seen running into families, though there is no concrete evidence of it yet. Therefore, it can be stated that even though the exact cause of the condition is unknown, it seems to be affected by genetic, hormonal, and environmental factors. Diagnosis of Keratoconus is easy, mainly from routine eye examination by an expert ophthalmologist.

Implications on Vision:

Though Keratoconus itself does not lead to blindness, it causes poor vision by an unclear cornea which is unable to focus light properly on the retina, leading to a distorted, blurry vision and glare. It changes the shape of the cornea, leading to its thinning and scarring, making it lose its transparency. Keratoconus progresses very fast in young patients, and hence it is important that immediate medical help is sought. Some of the symptoms of the condition include eye pain and strain, sudden change of vision in one or both eyes, double vision with just one eye, sensitivity to light, glare, headaches, blurry and distorted vision, seeing halos or light streaks and inability to drive after dark.

Treatment of Keratoconus:

Only prescription glasses are generally recommended to correct the vision in the early stages of Keratoconus. However, this is not a permanent solution because this condition rapidly progresses leading to further deterioration of the vision. In that case, one of the following treatments might be recommended by the ophthalmologist depending on the severity of the condition.

1. Hybrid or rigid contact lenses can be prescribed to improve vision by masking the shape of the cornea. But, that does not prevent further deterioration of vision.

2. When the vision is no longer correctable by using glasses or contact lenses, corneal ring segments are employed. These plastic segments are implanted into the cornea by a surgical procedure and they keep the shape of the cornea intact, leading to refractive correction of vision eventually.

3. Corneal collagen cross-link stops the progression of the Keratoconus. In this procedure, the outer layer of the epithelial tissue on the cornea is removed. It is then enriched with riboflavin and collagen, which are activated by the application of ultraviolet light to strengthen the cornea by improving its rigidity significantly. It requires some weeks of care after the procedure.

4. Keratoplasty or corneal transplantation is employed only when no other option works  for an individual. It is a complex surgical procedure in which a donor cornea replaces the defective cornea. Eventually, corneal cells grow and fuse with the donor cornea during the process of recovery, which can take up to almost a year.

People with even a small degree of the condition should not opt for the LASIK as it may worsen the condition.

Urgent referral is not required in Keratoconus as the condition manifests itself slowly, generally over a span of months and years. However, symptoms should not be ignored and medical help should be sought as soon as possible.