Conical Cornea

Hello everybody,

I am Dr. Ruchi, ophthalmologist, practicing in Faridabad. Today I am going to give you some information about corneal disease which we are commonly finding it these days. It is keratoconus or commonly known as the conical cornea. The cornea is basically a transparent structure which is in front of the Iris and the lens and is an optical surface from which the light rays pass and form the image on the retina. This corneal surface is a curved structure with about 11.5 mm diameter and the thickness central thickness of the cornea is about 0.5-0.6 and in Indian eyes, we generally take it around 540 which is an average diameter the central corneal thickness. Now, what happens at times is that the cornea is curved structure uniformly but at times it is at places flattened at places steeper. So the light rays falling on this cornea they disperse, they do not focus on the retina in fact they disperse and the image becomes blur. To correct this dispersion of the light we have to put lenses which we call cylindrical lenses with the axis and it is known as Astigmatism. It is also seen that is at times the Astigmatism is very high.

In children we are finding it very commonly around -2, -3 beginning of the cylindrical power and around the age of 9 to 12, we must keep a check on this curvature of the cornea. As the height will increase, as the body growth will take place, the cornea the eyeball will also increase in size and the cornea also changes its shape. So we check for the curvature of the cornea and we check for the central thickness of the cornea because when the cornea is getting more curved, the periphery becomes it becomes more curved like this. So, the central portion becomes very thin. So, generally as a base investigation, we check for children with high cylindrical power for the corneal curvature and the central thickness. In case we find something wrong in that, the cornea becomes thinner or the curvature is steeper which is around say around the reading of 47, 49, 50 or so, then you go in for further investigations like Pentacam.

At the common there is a treatment for this this is C3r which is a laser treatment for the correction of the corneal structure for corneal surface but not for the removal of the lens. This is done by the cornea specialist and at times we also see that women during pregnancy, after delivery or sometimes in adults after the body growth has stopped but still the power suddenly increases, that is a strong indication that please do get your cornea examined by your doctor because it could be a sudden changes in the corneal curvatures. This can be a very risky factor also because if the cornea in the centre becomes very thin it can lead to severe damages, complications which can be then treated by the cornea transplant only.

But if we keep an assessment over the period of time for the children and young adults about the corneal surface measurements and the central corneal thickness, then we can at an early stage get this laser treatment C3r or just keep an eye on the changes in the power and correct it. So that is what I wanted to tell you about this keratoconus. There are patients whom we suggest that do not do get the corneal central corneal thickness and the corneal curvature tested but they are not aware of this conical cornea or the keratoconus and they avoid getting it. But please if your doctor suggests you then you must get this these investigations to done.

Thank you!