Keratoconus

• Signs/ symptoms
• Diagnosis
• Cause
• Treatment
• Prevention

• It is a progressive disease of the outer transparent layer of the eye (cornea) affecting young adults. It is characterized by progressive thinning of the normally round cornea causing it to bulge forward forming a conical shape. This irregularity in the cornea results in the formation of a distorted image of objects on the retina & gives rise to blurred vision.


Symptoms & signs

• Blur vision even with glasses.
• Frequent change in glasses prescription with fluctuation in vision.
• Glare & sensitivity to light especially during night.

Diagnosis

Keratoconus can be diagnosed at an early stage with detailed eye examination which includes retinoscopy,Slit lamp examination & tests like corneal topography to check the shape & curvature of cornea & Pachymetry to determine the thickness of the cornea.

Corneal topography

Cause

Exact causes of Keratoconus is not known but it may have some genetic predisposition. It may transmit from parent to children & affect more than one family member. It is also associated with excessive rubbing as it is more common in allergic conjunctivitis patients who have itching & tend to rub their eyes more frequently.
Other risk factors are overexposure to ultra violet rays, chronic eye irritation & improperly fitting contact lenses.

Treatment

1) Glasses/ Contact lens

In early stages, when the cornea is still regular, corrective prescription glasses or soft contact lenses can help the patient. As keratoconus advances, the corneal surface becomes increasingly irregular & these options do not help adequately. In intermediate & advanced stage, various other treatment options & different types of contact lenses are available. Rigid Gas permeable contact lenses provides a smooth refractive surface replacing the irregular cone like surface of the cornea, thus enabling the patient to see clearly. Apart from RGP there are other lenses specially for keratoconus patients like Piggy bag lenses, Scleral lens, Minisclerals, Hybrid lenses.

2) Surgical

C3R (CORNEAL COLLAGEN CROSSLINKING) with riboflavin is the latest addition to treatment option for early progressive keratoconus. This is minimally invasive day care procedure that stabilizes the keratoconus and prevents further deterioration of vision. With newer corneal topography equipments it is easy to pick up early keratoconus and C3R in such cases further progression of keratoconus and thus reduces visual morbidity. C3R is a safe procedure for early progressive keratoconus.

C3R Procedure

3) Keratoplasty

This involves corneal transplantation either full thickness (PK- Penetrating Keratoplasty) or only the anterior layers (DALK- Deep Anterior Lamellar Keratoplasty)

PENETRATING KERATOPLASTY

In penetrating keratoplasty the entire recipient cornea is replaced with full thickness donor cornea. This type of penetrating surgery is usually indicated for full thickness corneal opacity, failed grafts and macular corneal dystrophy.

PENETRATING KERATOPLASTY

DALK (Deep anterior lamellar Keratoplasty)

This is one of the recent modification of keratoplasty where full thickness transplantation is not done. This type of transplantation involves replacing only the superior three diseased layers of cornea with healthy donor tissue This procedure has faster recovery period and minimal risk of rejection. Also visual outcome is better. This surgery is indicated in cases with advanced Keratoconus, superficial scar.

Prevention

• If there is a genetic predisposition of a family history then all family members should be screened timely.
• Regular eye checkup starting at an early age is a must.
• Close watch on glasses power fluctuation can help detect keratoconus at an early stage.
• Avoid excessive eye rubbing and treat eye allergies ealrly.

Keratoconus if diagnosed at an early stage can help us preserve vision and improve the quality of life.

Why chose us?

At Sanjeevani Eye Hospital we are eqipped with the most advaced Scheimflug imaging system to capture the corneal curvature and detect keratoconus at the earliest stage the PENTACAM topograher. Let us guide you further in detail about keratoconus and its treament. Please feel free to contact us for any further querries or doubts. We are always glad to help you.