Keratoconus

The cornea, the transparent dome-shaped front part of the eye, acts as a powerful lens and allows for the majority of the focusing of the eye. To function properly it must be smooth and appropriately shaped. 

Keratoconus causes the central area of the cornea to become weak and thinner and this leads to an abnormal bulge in the shape. This causes the eye to become more short sighted, have increased astigmatism, and this results in the vision becoming distorted. It is usually first diagnosed in the form of an astigmatism where the cornea is seen to bulge slightly, which in turn, will impair the eyes’ ability to focus.

What are the Symptoms?

Common symptoms of keratoconus include

  • blurred vision
  • increasing myopia
  • increasing astigmatism
  • distorted vision
  • glare
  • haloes around bright lights
  • poor vision not correctable with glasses or soft contact lenses

What is Keratoconus?

Keratoconus causes the central area of the cornea to become weak and thinner and this leads to an abnormal bulge in the shape. This causes the eye to become more short sighted, have increased astigmatism, and this results in the vision becoming distorted. It is usually first diagnosed in the form of an astigmatism where the cornea is seen to bulge slightly, which in turn, will impair the eyes’ ability to focus.

What are the Causes?

The cause of keratoconus is unknown. There are probably several genetic components as approximately  5% of cases run in families. It most commonly first becomes noticed in early adulthood and is more common in certain individuals, including those with significant allergy or “atopy” such as eczema and asthma. Some atopic patients with keratoconus have a history of eye rubbing which is known to induce progression through microscopic corneal trauma. 

What is the Diagnosis?

The diagnosis and severity of keratoconus is defined by subjective and objective measures.  These include visual acuity (unaided, aided with glasses, aided with contact lenses); glare; ability to see and drive at night; ability to wear gas permeable or other contact lenses; cornea scarring; manifest refraction (strength of the glasses prescription); cornea topography (shape) and pachymetry (corneal thickness).

What Treatments are available?

Modern treatment modalities for keratoconus are designed to stabilise the progression and improve the visual performance of the eye.

Current treatments include:

  • Specialist Contact Lenses
  • Corneal Collagen Cross Linking (CXL)
  • Intra-Stromal Rings
  • Topography Guided PTK combined with CXL
  • Implantable Contact Lenses
  • Corneal Transplantation
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