A Complete Guide to Keratoconus Management
Overview of Keratoconus
Keratoconus is a progressive eye disorder characterized by the thinning and bulging of the cornea, the clear front surface of the eye. Keratoconus may progress slowly over time. It is thought that a combination of genetic predisposition and external factors like eye rubbing, eye allergies, collagen disorders may contribute to the development of keratoconus.
The impact of keratoconus can be significant and may vary depending on the severity of the condition. In addition to the visual impact, keratoconus can have a psychological and emotional impact on individuals.
It’s common symptoms include blurred or distorted vision, increased sensitivity to light, glare, and frequent changes in eyeglass or contact lens prescription.
Causes of Corneal Thinning/Keratoconus:
- Genetic Factors: Keratoconus can be hereditary and run in the person’s family. So, having a family member with keratoconus may increase the risk of developing the condition.
- Collagen Abnormalities: The cornea is primarily composed of collagen, a protein responsible for maintaining its structural integrity. There may be abnormalities in the structure or function of the collagen fibers, leading to weakening and thinning of the cornea.
- Eye Rubbing and Mechanical Stress: Frequent and vigorous eye rubbing, particularly in individuals prone to allergies or chronic eye irritation, may contribute to keratoconus and progression of keratoconus. The mechanical stress from eye rubbing can weaken the cornea and contribute to its abnormal shape.
- Chronic Eye Inflammation: Some eye conditions, such as chronic eye inflammation (e.g., ocular allergies or inflammatory disorders), can lead to corneal thinning due to prolonged inflammation and tissue damage.
Risks that people with keratoconus may experience
While the primary concern with keratoconus is the visual impairment, there are several additional risks associated with this condition. These include:
- Reduced Visual Acuity: As keratoconus progresses, blurred or distorted vision, increased sensitivity to light, and difficulty focusing can significantly impact daily activities.
- Frequent Prescription Changes: Keratoconus often necessitates frequent changes in eyeglass or contact lens prescriptions. As the cornea continues to change shape, the optical correction required to achieve clear vision may need to be adjusted regularly.
- Contact Lens Intolerance: As keratoconus advances, wearing contact lenses can become increasingly challenging. The irregular corneal shape makes it difficult for traditional contact lenses to fit properly, causing discomfort, irritation, and poor vision.
- Corneal Scarring: In some cases, keratoconus can lead to corneal scarring. The risk of corneal abrasions or erosions increases. These injuries can result in scarring, further impairing vision and potentially requiring additional interventions.
- Vision Distortions and Halos: Keratoconus can cause visual distortions, such as multiple images, streaking, or halos around lights. These visual anomalies can affect tasks like driving at night or reading fine print, diminishing quality of life and increasing the risk of accidents or difficulties in daily activities.
Who can opt for Keratoconus treatment?
The following People may opt for Keratoconus Management:
- People with Visual Symptoms: People experiencing visual complications from blurred or distorted vision, frequent changes in glass power, poor night vision, and increased sensitivity to light may benefit from keratoconus management.
- People with Corneal Thinning: Individuals with corneal thinning may opt for keratoconus management, as detected through corneal topography or other diagnostic tests.
What is Keratoconus Management?
Keratoconus management involves a range of treatment options aimed at improving vision, slowing down the progression of the condition, and maximizing visual acuity. The management approach may vary depending on the severity of keratoconus and individual patient factors. Certain symptoms which are treated in Keratoconus management are blurred or distorted vision, frequent changes in eyeglass prescription, increased sensitivity to light, poor night vision, and eye irritation and discomfort.
Depending on the stage of progression various treatment modalities are available. These include some common Keratoconus management strategies:
- Lenses The lens-based treatment is advised in mild & moderate cases of keratoconus. In the early stages of keratoconus, eyeglasses may be sufficient to correct vision and provide adequate visual acuity. As the condition progresses, special contact lenses such as rigid gas permeable (RGP) lenses or scleral lenses are often prescribed to provide better vision by providing a smoother corneal surface.
They may be advised in early cases which may be either soft contact lenses, hybrid lenses, piggy- back lenses, scleral lenses or Rose K lenses.
- Corneal Cross-Linking: Corneal cross-linking is a non-invasive procedure and is done for progressive keratoconus. It is aimed at strengthening the cornea and halting the progression of keratoconus. This process helps create additional cross-links within the corneal collagen fibers, increasing corneal strength and stability.
- Surgery The surgery-based treatment can be done with or without a laser to reshape the cornea. It also includes Corneal Ring Implants but not all surgeries require ring implants. If corneal ring implantation needs to be done it will require the placement of small, clear, semi-circular plastic rings within the cornea to reshape its curvature and improve vision. Corneal ring implants can be removed or exchanged if necessary. Afterwards, lenses and glasses are also prescibed by the doctors after the surgeries as a safety precaution.
- Corneal Transplant: In advanced cases of keratoconus where other treatments are not effective or feasible, a corneal transplant may be considered. During this procedure, the damaged cornea is replaced with a healthy donor cornea. Various types of corneal transplantation techniques are available.
Benefits of Keratoconus Management:
- Improved Visual Acuity: By utilizing various treatment options, such as specialized contact lenses, scleral lenses, or corneal cross-linking, the cornea’s shape can be corrected or stabilized, leading to clearer vision.
- Increased Contact Lens Comfort: Advanced contact lens designs like scleral or hybrid lenses are beneficial to the patients in terms of the comfort.
- Benefits of Cross-Linking: Corneal cross-linking is a recommended treatment for rapidly progressing keratoconus as it strengthens the cornea, slowing down its progression and preserves the vision.