Everything You Need To Know About Keratoconus?
Written by Dr. James Lehmann on 06/19/18
There is a common misconception that eyeballs do not grow after we are born. Our eyes do grow as the rest of our body grows, but at a slower pace than any other part. Different parts of the eye may grow at a different pace; if your cornea starts to grow and become more thin and out of shape, you may have trouble with your vision and experience the symptoms of Keratoconus.
What Is Keratoconus?
Keratoconus occurs when the cornea starts to thin out and the center of the cornea bulges out. This bulging causes a cone-like shape.
The cornea is important to our eyes for a variety of reasons. It is the outermost layer of the eye, and contains five layers of membranes that each have different functions. All five layers help to protect the rest of the eye from dirt, bacteria, and other substances that our eyes might come into contact with throughout the day.
Our corneas also focus 65-75% of the images that we see. Without this refractive process, the images that we see may become blurry. When the cornea becomes thin and misshapen, light cannot be reflected as effectively. This is why keratoconus can cause distorted vision and become an issue for patients. Everyday tasks like driving, reading, or typing can become difficult for patients with keratoconus.
What Are the Symptoms of Keratoconus?
Symptoms of keratoconus include:
- Blurry vision
- Double vision
- Sensitivity to light
Not all of these symptoms automatically point to keratoconus. If you are worried that you have keratoconus, call up your eye doctor for a regular eye exam. During this exam, your eye care professional will measure the shape and size of your cornea.
What Causes Keratoconus?
Eye care professionals do not know for sure what causes keratoconus. There are a handful of theories that point to enzyme imbalances and exposure to UV rays as possible causes for keratoconus. Excessive eye rubbing is also associated with keratoconus (if you have been diagnosed with keratoconus, be careful to not rub your eyes. Rubbing your eyes can cause further damage to the cornea.)
Similar patterns have been found in patients with keratoconus. If you have a parent that has keratoconus, for example, you might be at a higher risk of getting keratoconus. One in ten cases of keratoconus are genetic. Keratoconus is a corneal dystrophy that affects both eyes. This condition affects 1 in 2,000 people.
Symptoms usually appear in the late teenage years, and may continue to progress throughout the patient’s lifetime. This process happens more quickly for some patients than others.
How Is Keratoconus Treated?
Keratoconus symptoms range from mild to severe. When patients are first diagnosed with keratoconus, they may be able to address the problem with eyeglasses. Mild cases of keratoconus can be corrected with soft contact lenses, but as the condition progresses, contact lenses may no longer be a viable option.
If the condition becomes more severe, treatments are available to correct the cornea’s cone-like shape. Keratoconus treatments typically do not eliminate the need for glasses or contact lenses to obtain perfect vision. Options for patients with keratoconus include:
Specially Designed Contact Lenses
There are many different types of contact lenses that patients with keratoconus can use to address their symptoms. If you have been diagnosed with keratoconus, talk to your eye care professional about:
- Custom soft contact lenses
- Gas permeable contact lenses
- “Piggybacking” contact lenses (two types of lenses in the same eye)
- Hybrid contact lenses
- Scleral and semi-scleral contact lenses
- Prosthetic contact lenses
In some cases of keratoconus, contact lenses will not be able to correct vision problems or adjust to the curvature of the cornea. Intacs, or intrastromal corneal ring segments, are inserts that are surgically placed into the periphery of the cornea. The inserts reshape the eye and have been proven to improve vision by two lines on a standard eye test.
Intacs can be the sole treatment needed to fix keratoconus. The inserts are also removable or exchangeable. If keratoconus continues to worsen with intacs, the inserts can only delay the time in which patients will have to get a corneal transplant.
When keratoconus continues to progress and contact lenses or intacs are no longer a solution, eye care professionals may recommend a corneal transplant. Corneal transplants replace diseased or affected corneas with a healthy and safe cornea donated by humans after their death. Depending on the severity of keratoconus, a corneal transplant may involve replacing one or more layers of the cornea. The entire cornea may be replaced if the keratoconus is severe.
Corneal crosslinking is the newest treatment for keratoconus. This process involves dropping Vitamin B2 into a patient’s eye and exposing the cornea to UV rays. The combination of B2 and UV rays forms a chemical reaction that hardens the cornea and stops the keratoconus from becoming more severe. The process will not bring the cornea back to its original rounded shape, but it has been proven to halt the progression of keratoconus in 94% of patients.
Corneal crosslinking has only been around for 10 years, but provides a less invasive alternative to traditional treatments for severe keratoconus. Like other treatments, patients will still have to wear glasses or contact lenses in order to see with optimal vision.
Which Keratoconus Treatment is Right For Me?
If you are looking to correct keratoconus, you have a lot of options for treatment. Before you move forward with a treatment, talk to an eye care professional about your options and hear their recommendations. Some treatments, like the corneal transplant surgery, are more invasive than others, but are one of the few options available for more severe keratoconus. Cost may also play into which treatment is best for you; newer treatments like corneal crosslinking are more expensive due to the fact that they are new on the market.
If you want to learn more about treating keratoconus, reach out to the experts at Focal Point Vision. We have the sole corneal crosslinking device in San Antonio that has been approved by the FDA. Over 160 patients have gone through corneal crosslinking in our office and enjoyed better vision.