Keratoconus Causes, Symptoms and 10 Treatment Options
Written by Dr. James Lehmann on 09/21/18
Scientists used to believe that the degenerative eye disease, keratoconus, occurred in one in every 2,000 people. With the advance of LASIK technology, however, it’s been found that there are many more cases which have been previously undiagnosed or misunderstood. The rate of the disease could be five times higher than ophthalmologists had thought.
While it is a progressive disease, there are many keratoconus treatment options which can help to prevent the condition from getting worse. This article will show you the causes, symptoms, and treatment options available to someone diagnosed with keratoconus.
What is Keratoconus?
Keratoconus, also known as KC, is a non-inflammatory progressive eye disease. The cornea is usually a dome shape, but this changes and thins over time in a keratoconus patient. The dome gradually forms a cone shape instead, affecting a person’s vision until it becomes a significant impairment.
The average age of diagnosis is 28 years old, although some younger people will show signs earlier.
Causes of Keratoconus
Nobody really knows what causes this non-inflammatory eye disease. Some studies have suggested a genetic link, which means people whose parents have had keratoconus are more likely to get it.
Symptoms of Keratoconus
There are several symptoms of KC which may all be signs of different eye diseases. When two or more are present then it increases the likelihood of KC being the cause.
Sudden Change in Vision in One Eye
A rapid change in vision is most likely to occur in just one eye when it is KC related. This is due to the cornea shape altering over a short amount of time.
New Near-Sighted Vision
If you can only see things when they are close to you, and far away objects look blurry, this can be a sign of KC when you experience several other symptoms at the same time.
Bright lights may look like they have halos around them, especially at night, in a KC case. This is due to the warped cornea providing a wavy surface that refracts light differently to a domed cornea.
You may also experience generalized sensitivity to light. This could include needing to wear sunglasses on a cloudy day or finding bright lights in darkness, such as at nightclubs, overwhelming.
Double Vision in One Eye
If you close one eye and start seeing double then you could be showing signs of keratoconus.
Eye Swelling or Persistent Redness
The changes in the cornea can cause your eye to swell. This may result in persistent redness or swelling in your eye.
Keratoconus Treatment Options
KC takes a long time to progress in most cases. It will deteriorate over ten to twenty years in most patients, then often stabilize at a stage of significant vision impairment.
There are many treatment options for keratoconus, depending on the severity of the case and how quickly it has been diagnosed. The change in the cornea presents as astigmatism, which can often be corrected with glasses or contact lenses to prevent significant deterioration for a long period of time.
1. Prescription Eyeglasses
For mild or early keratoconus, the first step to treatment is prescription eyeglasses.
The lenses will help to correct vision and add clarity, but will not prevent the long-term progression of the disease.
2. Custom Soft Contact Lenses
Soft contact lenses designed for a KC patient will correct presenting astigmatism without the need for eyeglasses. These custom lenses are made entirely bespoke for the individual based upon their exact measurements and sight correction requirements.
3. Gas Permeable Contact Lenses
Gas permeable contact lenses can also work for keratoconus as they allow more oxygen to the eye than standard lenses. This means they can be worn over a longer period of time with a higher level of comfort.
The shape of a gas permeable lens is also slightly different from other contact lens options like hybrids. Instead of sticking to the eye, a gas permeable lens sits above in an arc to allow gas to permeate and circulate. This provides a smooth surface for light refraction, which makes these lenses an option for moderate KC patients.
4. Hybrid Contact Lenses
Hybrid lenses have a hard central element surrounded by a soft border. The hard central part gives a smooth surface to correct the problems experienced with a wavy KC cornea. The soft outer ring helps to add comfort to the lens.
5. PhotoRefractive Keratectomy
For very mild and early cases of KC, PRK can help to reshape the cornea. It is similar to LASIK eye treatment except there is no flap created on the cornea.
PRK is ideal for those showing early signs of astigmatism and can help slow down the need for glasses or contact lenses.
6. Scleral Lenses
Scleral lenses are larger than standard hybrid, custom, or gas permeable contact lenses. The outer edge of the lens sits on the white of the eye, called the sclera.
The shape of this lens relieves pressure on the eye as the dome arcs over the center instead of sitting directly on top.
When contact lenses or eyeglasses no longer fully correct vision in a KC sufferer, intacs may be used. These tiny plastic inserts are placed on the outer edge of the cornea to help reshape it.
8. Corneal Transplant
A corneal transplant is for KC patients who no longer have success with the other keratoconus treatment routes.
The cornea is surgically replaced with a donor cornea. Sight will improve but the patient is likely to have a continued need for prescription glasses.
9. Keratoplasty (TPK)
Topography-guided conductive keratoplasty is a new treatment that can help to smooth the irregular surface of the cornea in a KC patient.
A small probe is placed in several areas around the cornea and radio waves are applied. This system can reshape the surface of the eye to reduce KC symptoms with significant effect.
10. Corneal Crosslinking (CXL)
Corneal crosslinking can stop the deterioration of corneal bulge by improving the strength of the tissues in the cornea. There are two approaches: one removes the external layer of the cornea while the second approach leaves it intact.
The first approach, epithelium-off CXL, will work more quickly but does have a longer recovery time. There is less evidence of the efficacy of epithelium-off CXL at this point in time.
Vitamin B, riboflavin, is added to the cornea before being exposed to UV light. This strengthens the corneal tissues to prevent further bulging.
Find a Specialist for Treatment
If you have experienced symptoms of keratoconus, or received a recent diagnosis, it’s important to seek out a specialist for ongoing help.
Keratoconus treatment can be tailored to each individual case depending on the severity and progression of the disease, as well as the lifestyle of the patient.
Contact us today to find out how our services could help treat your keratoconus.