An ophthalmic condition that is characterized by progressive distortion of the corneal surface. This condition is non-infectious, noninflammatory, and involves both corneas. This ectatic condition manifests with a cone-like protrusion of the cornea with an irregular surface. The light passes and reflects through the cornea just like a mirror and if the surface is irregular then the image will be distorted. Therefore, the patients usually experience decreased visual acuity, image distortion, and photosensitivity.
Unlike other visual problems, keratoconus cannot always be corrected with usual spectacles. Keratoconus typically occurs at puberty and may progress after 30 years of age. Most of the patients may remain asymptomatic due to mild corneal distortion. Keratoconus is a progressive condition so visual problems may develop over time. Early diagnosis and treatments of keratoconus may prevent visual disturbances and loss of vision.
What are the causes of keratoconus? 2
The exact cause of keratoconus is unknown but the following conditions may increase the chances of disease:
Wearing rigid contact lenses
Rubbing of eyes (chronic)
Connective tissue disorders
Family history of keratoconus
What Are The Signs And Symptoms Of Keratoconus?
Keratoconus may remain asymptomatic for extended periods. This condition is bilateral but may be asymmetric. If visual distortion or blurriness is noticed, glasses may or may not help. A patient of keratoconus may present with the following signs and symptoms depending upon the degree of corneal distortion:
Blurring of vision
Formation of glares and halos around light
Seeing ghost-like images
Sensitivity to light
Decreased vision in low light conditions
Pain behind eyes
Multiple failed attempts at spectacle correction
Severe keratoconus may be associated with:
Increased corneal irregularity (checked by an ophthalmologist)
Increase in severity of existing symptoms
How Is Keratoconus Diagnosed? 1
Unlike other eye diseases, keratoconus doesn’t require laboratory investigations. Diagnosis of keratoconus is made with the help of the following:
Slit lamp eye examination
Tear fluid level
What Is The Treatment Of Keratoconus? 1,2
The management of keratoconus depends on the stage of disease and progression. If keratoconus is not progressing then management aims to correct visual disturbances. If keratoconus is progressing then treatment aims to stop the progression. If the disease is diagnosed at an early stage then minimally invasive treatment options can lead to good results.
Custom contact lenses to fit a patient’s corneal surface may provide some control of the disease.
For mild to moderate keratoconus, Rigid Gas Permeable contact lensesare used for visual improvement. The tear layer between the cornea and contact lens may negate the surface irregularities but these rigid contact lenses can be difficult to wear for longer durations.
Corneal collagen cross-linkingis an outpatient procedure that increases the corneal rigidity and slows the progression of keratoconus. Studies show that corneal collagen cross-linking decreases the need for future invasive treatments.
Corneal collagen cross-linking can also be combined with laser ablation of the corneal surface to improve outcomes. This technique is being used outside of the USA.
Intracorneal ring segments may be applied to flatten the corneal surface
If symptoms are severe and not resolved with treatments as mentioned above then a corneal transplant is the last resort.
Keratoconus is a progressive distortion of the corneal surface that can result in visual disturbances and even blindness. If diagnosed at an early stage then keratoconus has a good prognosis. If you’re facing any of the aforementioned signs or symptoms, contact your ophthalmologists for a full evaluation.
NCBI - WWW Error Blocked Diagnostic. (n.d.). NCBI. Retrieved August 12, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK470435/
Yeung, K. O. K. D. (2022, March 9). Keratoconus: Practice Essentials, Background, Pathophysiology. Medscape. Retrieved August 12, 2022, from https://emedicine.medscape.com/article/1194693-overview
What Is Keratoconus? (2022, March 25). American Academy of Ophthalmology. Retrieved August 12, 2022, from https://www.aao.org/eye-health/diseases/what-is-keratoconus
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