Written by Dr. James Lehmann on 01/3/19

What is Keratoconus?

The word itself is quite a mouthful.

Keratoconus means “cone-shaped cornea.” The condition is characterized by a progressive thinning of the cornea. This causes the center of the cornea to bulge outward and form a rounded cone shape.

The National Eye Institute states that this disease is the most common corneal dystrophy in the country. It affects one in 2,000 Americans. For this reason, it’s important to understand what it is and what your treatment options look like.

Patients with keratoconus often report decreasing vision. They’ll also often experience multiple unsatisfactory attempts in obtaining optimum spectacle correction.

Are you interested in learning more about Keratoconus and Keratoconus care? If so, read this guide.

History of Keratoconus

A German professor, Burchard Mauchart, first described Keratoconus in a doctoral dissertation in 1748. He described it as “Staphyloma Diaphanum.”

Before this, there was little mention of the condition. Many physicians simply referring to it as “Ochlodes” meaning “annoying” in Greek.

In 1854, a British physician, John Nottingham, called the condition “Conical Cornea.” Many of his insights and features of it are still understood as true today.

In 1859, William Bowman was the first person to use an ophthalmoscope to observe Keratoconus. John Horner, a Swiss physician, finally gave the condition its modern name, Keratoconus, in 1869.

These days, the medical understanding and grasp of Keratoconus is extremely sophisticated. It’s now differentiated into a mild, moderate, and advanced disease.

What’s the Cause?

The cause of Keratoconus is relatively unknown. Although not definitely identified, doctors have formed a general understanding of the risk factors involved.

There is strong evidence showing that those with a parent who has KC, have a much higher chance of developing it.

Other than genetics, some other causes include: ocular allergies, systemic and ocular associations, eye rubbing and atopy. In several reports, it’s suggested there is an association between keratoconus and other corneal dystrophies.

Keratoconus Progression

In most cases, KC takes quite a while to progress.

Most people will experience a slow deterioration over 10-20 years. After this, it often stabilizes to a point where vision is severely impaired.

Each case will differ in severity and this will help guide what type of treatment is most appropriate. Luckily today, there are a variety of treatment options available to people in any stage of KC.

From prescription for astigmatism glasses and contact lenses to Keratoconus surgery. These treatments have developed and improved greatly over the years.

Cataracts & Care

Everyone has a clear, flexible lens in their eye called a ‘crystalline lens’. If this lens becomes less flexible and less clear, it’s called a cataract.

Cataracts cause problems with contrast and glare, and cloudy distance vision. Sometimes, poor near vision is a symptom.

These days, there are many different types of technology capable of removing cataracts. Cataract surgery will replace the cloudy lens with an artificial, clear lens.

With the advanced technology, different implants are available for distance, intermediate and near vision. If you’re asking, “how to correct astigmatism?”, you’ve come to the right place.

Ultrasound energy is the traditional way to remove cataracts. These days, lasers are also used to make incisions, disassemble cataracts, and correct astigmatisms.

Keratoconus Care

The past few years have seen a positive shift in the standard of care for Keratoconus.

A transition to a more effective use of contact lenses and earlier surgical intervention has prevented the disease from progressing.

Arrested or delaying the progression of the disease has proved much more effective than only treating the symptoms as they play out.

Collagen crosslinking and intrastromal corneal ring segments are examples of minimally-invasive surgical treatments. Their aim is to replace or delay the needs for corneal grafting.

Contact Lenses

In the first stages of mild keratoconus, eyeglasses may be all that’s required to improve vision. However, as the cornea becomes increasingly irregular, eyeglasses are less effective at correcting vision.

Contact lenses (CL) may get prescribed. They work by creating an artificial, smooth surface on the front part of the eye. This significantly improves the cornea’s ability to bend light.

Most people diagnosed with Keratoconus are prescribed contact lenses when diagnosed and will continue to wear them throughout their lives. Contact lenses have been shown to be very effective.

However, it’s critical that the contact lenses prescribed are correct for the individual patient.

In addition, KC patients should be carefully and regularly monitored with frequent progress visits. Changes in the contact lens shape may be necessary, because of changes in the shape of the cornea.

These days, there are a variety of specialty contact lens designs developed with the specific needs of those with KC in mind. These custom-made lenses will provide the best comfort and vision as KC progresses.

Keratoconus Surgery

It’s been over 80 years since the first corneal transplant was performed on a KC patient. Today, it is still the standard of care for the most severe cases.

Transplants usually last decades with proper care, but individual results will vary.

Corneal Transplant

In a corneal transplant, the cornea is surgically replaced with a donor cornea. The tissue used for corneal transplants is donated from deceased organ donors.

After the operation, the patient may have to wear prescription glasses, but their vision will be greatly improved. Usually, a corneal transplant is for KC patients who haven’t had success with other keratoconus treatment routes.

Keratoplasty (TPK)

In this procedure, a small probe gets inserted into a few areas around the cornea. Radio waves are then applied, causing the surface of the eye to reshape. This reduces the symptoms of KC.

This is a new treatment and is shown to be very effective in helping to smooth the irregular surface of the cornea.

Corneal Crosslinking (CXL)

This procedure stops the deterioration of the corneal bulge. It does this by strengthening the tissues in the cornea.

There are two approaches. The first removes the external layer of the cornea and the other leaves this layer intact.

Knowledge Is Power

Everyone reacts differently when they’re diagnosed with Keratoconus. A lack of understanding and knowledge can instill fear.

Thus, it’s essential to equip yourself with as much information as you can about KC. Research will help you understand everything from cornea function to astigmatism glasses. You’ll see there’s nothing to fear.

Today, there are a variety of treatment options, meaning you’ll find one to suit your situation.

Remember, accepting KC as a part of your life is important. But this doesn’t mean you must surrender to the condition. Lean on the support and advice of professionals.

For more information about Keratoconus and Keratoconus care, please contact us. We’ll guide you through your options for treatment.