It is a well-known fact that the cornea or the eye's clear outer lens makes it possible for us to see the world. Usually, the cornea is curved and is similar in shape to a ball. Unfortunately, sometimes, the structure of the cornea is not sturdy enough to maintain its circular shape. Consequently, the cornea bulges outwards or downwards and results in an ocular condition known as Keratoconus.
What causes Keratoconus?
A natural question arises as to what causes Keratoconus? In the eye, collagen or minute protein fibres help in keeping the cornea stable. These protein fibres also prevent the cornea from bulging. Further, if these fibres become weak, they cannot maintain the shape of the cornea, and it starts becoming more and more cone-shaped.
A deficiency or a decline in protective antioxidants is also a factor that causes Keratoconus. These antioxidants help the eyes get rid of the damaging by-products produced by the corneal cells.
Ophthalmologists are of the view that Keratoconus tends to have a two hit hypothesis - genetic tendency and environmental insult. Keratoconus is an eye ailment that progresses more rapidly in people who are already suffering from some medical issues, including certain allergic conditions. People who indulge in chronic eye rubbing are also at a much higher risk of developing this disease.
The change in the cornea's shape from a ball shape to a cone shape can either take place quickly or can take several years. This can also result in conditions like blurred vision, glare, and halos at night. Also, these changes can stop at any time if one is lucky, or they can continue for decades. Unfortunately, presently there is no way of predicting how it will progress.
In most cases, Keratoconus affects both eyes, but the degree of damage varies from one eye to another. It usually develops in one eye and spreads to the other eye gradually.
In the case of severe Keratoconus, the stretched collagen fibres can lead to severe corneal scarring. In cases where the cornea's posterior end gets torn, people experience a persistent swelling that stays for a couple of months. Such a condition also results in a large scar over the cornea.
How Is Keratoconus Diagnosed?
An eye doctor may notice several symptoms during an eye exam, such as:
- A sudden change of vision in one of the eyes
- Double vision while looking with just one of the eyes
- Distorted images of objects regardless of the distance at which they are placed
- Experiencing halos around bright lights
- Lights streaking
- Double or triple ghost images
- Being uncomfortable driving due to blurry vision, especially at night
To be sure that one has Keratoconus, the doctor usually measures the shape of the cornea. While there are several different ways for measuring the shape, experts prefer the corneal topography method, which helps them analyse it in just a few seconds.
Eye experts also advise annual eye checkups, including corneal topography. They are also of the view that even if your corneal topography is normal in a year, it's still important to have this test performed every year as there may be subtle changes over a period of time. With the help of annual tests, an eye expert can compare the results to identify those changes if they're present.
Eye specialists believe that mild forms of Keratoconus can be treated with glasses or contact lenses. But, as the ailment progresses and the cornea becomes cone-shaped, doctors can advise a few surgeries. A few common surgeries that are undertaken for keratoconus treatment are:
Corneal collagen crosslinking -
A minimally invasive procedure done by ultraviolet lights and eye drops for strengthening the collagen fibers in the cornea. The procedure is used for patients suffering from keratoconus, which is defined as a condition in which the cornea grows thin and weak.
Corneal transplantation -
Doctors recommend corneal transplantation at an advanced stage of Keratoconus. This might involve performing a full-thickness procedure (penetrating keratoplasty) or a partial thickness procedure (Deep Anterior Lamellar Keratoplasty) in which only the affected layer is removed.
Why Choose Centre for Sight for Keratoconus Treatment?
Centre for Sight offers various treatment modalities for keratoconus treatment and is well equipped with advanced corneal evaluation devices like Corneal tomography systems (Pentacam & Orbscan), Corvis to assess corneal biomechanics & strength, which help in early detection and monitoring of the disease.
We offer Corneal Collagen Cross-linking (C3R or CXL eye surgery) for treating Keratoconus. We also provide Corneal transplantation or keratoplasty, which is defined as a surgical procedure in which a damaged cornea is replaced by donor corneal tissue.
A few state-of-the-art options at Centre for Sight for corneal transplant surgery include:
- Deep Anterior Lamellar Keratoplasty (DALK) or the Partial Thickness Transplant
- Full-Thickness/Penetrating Corneal Transplant (PK)
For more information on this or further assistance, reach our world-class team of corneal specialists today because we believe that every eye deserves the best.
Article: A Primer on Keratoconus Treatment
Author: CFS Editorial Team | Sept 04 2020 | UPDATED 06:10 IST
*The views expressed here are solely those of the author in his private capacity and do not in any way represent the views of Centre for Sight.