Keratoconus is a disease where the cornea starts thinning leading it to bulge out and form the shape of a cone. It is typically seen in both eyes of the patients from the age of 10 to 25.
In the early stages, Keratoconus can be managed by wearing glasses or soft contact lenses but later on glasses with higher power may be required. Cornea transplant is a permanent solution and is necessary at chronic conditions.
The symptoms of Keratoconus are blurred or distorted vision with increased sensitivity to light and night vision problems. In some cases, the cornea ruptures causing watery eyes.
Some of the causes include,
- Rubbing of eyes continuously
- Retinopathy, Retinitis Pigmentosa, and other eye conditions can cause Keratoconus
- Enzyme abnormalities and hereditary factors
- Usage of contact lenses for years
The doctor usually diagnoses Keratoconus by performing the following diagnostic tests:
- Eye Refraction: a device is used to study how light is refracted by the eye.
- Slit-lamp Examination: is used to study the shape of the cornea by dilating the retina.
- Keratometry: is used to assess the curve of the retina by projecting a circle of light focusing on the cornea to study the reflection.
- Computerized Corneal Mapping: is a method which can measure the thickness of the cornea by getting an image of it using various scanning techniques such as corneal topography, coherence topography, etc.
The doctor would recommend the following treatment options depending on the severity of the disease:
Non-Surgical Treatment Options
- Contact lenses and eyeglasses: can be used for moderate Keratoconus where the prescription should be changed depending on the bulging of the eye.
- Rigid contact lenses: are used when the cornea’s bulging increases where normal contact lenses will not be of much help. The gas permeable rigid contact lens is used which may cause some inconvenience but in most cases, the patients do get accustomed to it. Different types of rigid contact lenses are available to suit the patient’s cornea or the condition of Keratoconus.
- Hybrid contact lenses: are used for people who have difficulties with a hard contact lens. A soft outer cover surrounds the rigid center making it easier to use.
- Scleral contact lenses: are used for advanced Keratoconus where changes in the cornea are irregular. These lenses are placed on the sclera which is the white portion of the eye that passes above the cornea hence does not touch it.
Surgical Treatment Options
Surgical procedures are usually performed when the patient’s cornea is too thin and have scars on it. In these conditions, contact lenses or eyeglasses are of no use. The surgeon will use different surgical methods depending on the problems caused by Keratoconus.
Some of the common surgical techniques are:
- Corneal inserts: a crescent-shaped plastic material is inserted into the cornea, which can help retain the shape of the cornea.
- Cornea Transplant: is the only treatment for cornea that is too thin and has severe scars.
- Lamellar Keratoplasty: the anterior portion of the cornea is removed and replaced by new tissue.
- Penetrating Keratoplasty: the entire cornea is replaced by a new cornea.
- Deep Anterior Keratoplasty: the inner layer of the cornea is preserved while doing a replacement of the entire cornea to reduce rejection.