OPHTHALMIC CONDITIONS
Keratoconus
Corneal Ectasia
What exactly is keratoconus?
Keratoconus is a corneal condition. It is considered a non – inflammatory, progressive disorder and classified in corneal ectasias. It is in fact an unusual disease where the cornea (the clear window of the eye to the world) becomes distorted and takes a conical shape (bulges out creating a protrusion), altering the image formed on the retina (progressively evolving irregular astigmatism). Concurrently, there is progressive thinning, scarring, and eventually opacity in the area where the cone is formed. Most of the time, keratoconus affects both eyes and appears in young adults, impacting the productive years of an indivisual’s life.
What are the main causes of keratoconus?
Despite ongoing research and studies, the exact cause of keratoconus remains unknown. Possible causes are:
Genetic: The condition appears to be hereditary.
Environmental: Eye rubbing.
Hormonal: The condition might be associated with the endocrine system.
What are the main symptoms of keratoconus?
Patients with keratoconus commonly experience:
Distortion of images (due to irregular astigmatism)
Blurred vision
Persistent refractive fluctuations (changes in prescription glasses)
Decreased visual acuity (VA)
Light sensitivity (photophobia)
Difficulties in daily activities (driving, reading, writing)
Halos, monocular diplopia, or glare refractions at night
Headaches
How is keratoconus diagnosed?
Keratoconus can be challenging to diagnose in its early stages and requires the ophthalmologist to have scientific expertise and experience, as well as access to modern technological equipment. Necessary diagnostic and clinical examination tests for the disease include:
Corneal topography: Mapping the curvature of the cornea using special color scales
Keratometry: Determining the stage of the disease and the level of astigmatism
Corneal pachymetry (measurement of corneal thickness)
Retinoscopy
Direct ophthalmoscopy
Refractive assessment
Measurement of visual acuity (VA)
Anterior segment Optical Coherence Tomography (anterior OCT)
How can keratoconus be treated?
Depending on the stage of keratoconus and the patient’s age, always with the goal of stabilizing the condition, treatment options may include:
Glasses (temporary solution): For early stages of the eye disease to correct refractive errors.
Keratoconic contact lenses: semi – rigid air permeable, piggyback, hybrid, custom soft, and rigid lenses
Intracorneal ring segments (ICRS): Inserted into the corneal stroma to flatten it by changing the shape and position of the cone
Corneal cross linking (CXL): A corneal procedure using a special vitamin (riboflavin), combined with ultraviolet (UV) light to strengthen the cornea (becomes more resistant)
Corneal transplantation (keratoplasty surgical procedure): When the damage is very advanced and essentially the diseased cornea must be replaced with a corneal graft
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