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Keratoconus - All You Should Know!

Written and reviewed by
MBBS, DNB - Ophthalmology, MS - Ophthalmology, Cornea Fellowship
Ophthalmologist, Mumbai  •  33years experience
Keratoconus - All You Should Know!

Keratoconus is an eye problem where the cornea starts to thin and eventually its shape gets distorted. This disease is progressive in nature and can affect both the eyes. Due to this condition, your vision will get distorted, which can’t be corrected with prescription glasses. 

This condition mostly surfaces during one’s teenage years or early twenties. 

 What are the symptoms?

In this condition, the shape of the cornea is distorted. Due to this change in shape, you may face near-sightedness and astigmatism, in addition to blurred and distorted vision.

Another problem you may have is sensitivity to light and glare. Also, this condition can cause frequent fluctuations in your eyeglass prescription.

What causes it?

Earlier doctors did not know what caused Keratoconus. They were aware of the risk factors –

  • Rubbing one’s eyes in a vigorous manner.

  • A family history of keratoconus.

  • Certain conditions like hay fever, Down syndrome and retinitis pigmentosa can make your susceptible.

New research, however, has pointed towards enzyme imbalance in the cornea as the most likely cause. It has been found that an enzyme imbalance makes it susceptible to free radicals damage that can weaken the tissue of the cornea. 

Too much exposure to UV rays of the sun is also a risk factor of keratoconus.

Treatment

There are many ways to treat this condition. The exact method will be determined by your doctor based on how severe your condition. It will also depend upon how quickly the condition is progressing.

Mild versions of this condition can be treated with the help of contact lenses or eyeglasses. But if the disease progresses rapidly along with the shape of the cornea being significantly distorted then these treatment options won’t help. 

In such cases, you will have to turn to the following treatments – 

  1. Corneal crosslinking
    This procedure is used to strengthen the corneal tissue so that the eye surface does not bulge.
     
  2. Customized contact lenses
    There are specially designed soft contact lenses in the market for mild to moderate keratoconus. 
     
  3. Hard lenses
    Hard contact lenses (gas permeable) are an option if soft contact lenses don’t produce the desired results. They may appear uncomfortable initially, but once you get used to them you will be able to see very clearly. 
     
  4. Piggyback lenses
    If hard lenses are uncomfortable then the doctor might suggest piggybacking a hard lens on top of a soft contact lens.
     
  5. Hybrid lenses
    Hybrid lenses are also an alternative to hard contact lenses. They have a hard centre with a soft outer ring.
     
  6. Scleral lenses
    In very advanced cases, scleral lenses are preferred because they sit on the sclera (white part of the eye) instead of the cornea. The lens vaults over the cornea without making direct contact.
     
  7. Surgery
    If all methods fail then the doctor may recommend surgical methods like corneal inserts or a corneal transplant

In the first method, inserts are placed in the cornea to flatten the bulge and support the structure of the cornea to improve vision. 

A corneal transplant involves replacing the affected tissue with the donor tissue. This procedure is only recommended in cases of extreme corneal thinning.

In case you have a concern or query you can always consult a specialist & get answers to your questions!
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