What Is Keratoconus?

Keratoconus is a non-inflammatory eye condition in which the normally round dome-shaped cornea (the clear covering of the coloured iris and black pupil) becomes protruded and irregular. This eventually impairs the ability of the eye to focus properly, potentially causing poor vision. The term Kerato-CONUS simply implies that the cornea changes shape to become conical.

Risk Factor and Causes of Keratoconus
It is usually diagnosed in young people at puberty, in their late teens or early twenties but can occur later. It tends to progress until the 30’s or 40’s and then tends to stabilize.
The exact cause is unknown. It is believed that genetics and environmental factors play a role. It is not generally considered an inherited disease, although rarely in some families more than one individual can be affected.

How Keratoconus affects Vision?
Vision is often unaffected in the very early stages. It is important to remember that keratoconus doesn’t cause sudden loss of sight. If left unchecked, further changes in shape, thinning of the cornea and in advanced stages, scarring can cause loss of transparency of the cornea which impairs the ability of the eye to focus properly.

Symptoms

Blurred vision, usually one eye worse than the other eye. It often causes changes in vision requiring frequent glasses prescription changes, which clear the vision initially but later don’t help the vision as much.

Complications

Cornea scarring can develop in severe cases. Acute corneal hydrops can develop in advanced cases. This is a condition where the membrane on the back layer of the cornea (Descemet’s membrane) tears and allows fluid to build up in the cornea causing pain and poor vision.

Tests And Diagnosis

The diagnosis can usually be made during a slit lamp examination. Additional testing includes corneal curvature and thickness mapping (corneal topography and tomography) and measurement of the corneal thickness (pachymetry). Anterior segment optical coherence tomography (AS-OCT) may be helpful in some cases

Treatments For Keratoconus

In the early stages, glasses or soft contact lenses may be used to correct vision. As the cornea becomes thinner and steeper, soft or specialist rigid gas permeable (RGP) contact lenses are often required to correct vision more adequately. In very advanced cases, where contact lenses fail to improve vision, a corneal transplant may be needed. This type of intervention is now rare since the introduction of ‘Cross-Linking’ (CXL). CXL is a relatively new treatment that can stop the disease getting worse. It is effective in over 94% of patients with a single 30 minute outpatient procedure. CXL works best in the early stages of keratoconus.

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