Keratoconus (Symptoms,Causes and Treatment)

Keratoconus is an eye disorder that affects the cornea, the clear outer layer of the eye that helps focus light on the retina. In keratoconus, the cornea becomes thin and bulges outward into a cone shape, which can cause distorted and blurred vision. The condition typically develops in adolescence or early adulthood and may progress over time. In some cases, it can lead to scarring and vision loss. Treatment may include glasses or contact lenses, but in more severe cases, a corneal transplant may be necessary.

This article covers the following topics :

What is keratoconus?

Keratoconus is a progressive eye disease that affects the shape of the cornea, the clear, dome-shaped surface that covers the front of the eye. The cornea normally has a round, symmetric shape, but in keratoconus, it thins and bulges outwards, resulting in a cone-like shape. This irregular shape can cause significant vision problems, including nearsightedness, astigmatism, and distorted or blurry vision.

The exact cause of keratoconus is not fully understood, but it is believed to be a combination of genetic and environmental factors. It typically begins in the teenage years or early twenties and can progress over several decades. In some cases, keratoconus can be associated with other conditions, such as allergies, eczema, or Down syndrome.

The signs and symptoms of keratoconus can include:

*Blurred or distorted vision

*Sensitivity to light

*Frequent changes in eyeglass or contact lens prescriptions

*Halos or glare around lights

*Eye strain or fatigue

*Eye redness or swelling

Keratoconus is usually diagnosed through a comprehensive eye exam, which may include:

*Visual acuity test to measure how well you can see at various distances

*Refraction test to determine your eyeglass or contact lens prescription

*Corneal topography to map the shape of your cornea

*Pachymetry to measure the thickness of your cornea

*Slit-lamp exam to evaluate the front part of your eye

*Dilated eye exam to examine the back part of your eye

Treatment for keratoconus depends on the severity of the disease and the individual’s specific needs. In the early stages, glasses or soft contact lenses may be sufficient to correct vision problems. As the disease progresses, rigid gas permeable (RGP) contact lenses may be needed to provide better visual acuity and prevent further corneal distortion.

In more severe cases, corneal cross-linking may be recommended. This is a procedure that uses ultraviolet light and a photosensitizing agent to strengthen the cornea and prevent further bulging. Other treatment options may include intacs, which are small plastic inserts that are surgically placed into the cornea to help flatten it, or corneal transplant surgery.

It is important for individuals with keratoconus to have regular eye exams and to work closely with an eye care professional to manage their condition. With proper treatment, many people with keratoconus can achieve good vision and maintain their quality of life.

What are the symptoms of keratoconus?

The symptoms of keratoconus can vary depending on the severity of the condition. In the early stages, a person may not experience any noticeable symptoms. However, as the condition progresses, symptoms may include:

1-Blurred or distorted vision: This can occur because the cornea becomes misshapen, which can cause images to be distorted or blurry.

2-Sensitivity to light: People with keratoconus may experience increased sensitivity to light, especially bright lights.

3-Eye strain: Because the cornea is misshapen, the eyes may need to work harder to focus, which can cause eye strain and fatigue.

4-Headaches: Eye strain and fatigue can also cause headaches.

5-Poor night vision: People with keratoconus may have difficulty seeing in low-light situations, such as at night.

6-Double vision: In some cases, keratoconus can cause double vision.

7-Frequent changes in prescription glasses or contact lenses: As the shape of the cornea changes, prescription glasses or contact lenses may need to be updated frequently.

It’s important to note that these symptoms can also be caused by other eye conditions, so it’s important to see an eye doctor for a proper diagnosis.

Why do people get keratoconus?

The exact cause of keratoconus is not fully understood, but it is believed to be a combination of genetic and environmental factors. Some studies suggest that people with a family history of keratoconus may be at a higher risk of developing the condition. Other factors that may contribute to the development of keratoconus include eye rubbing, chronic eye irritation or inflammation, and hormonal imbalances. Additionally, certain genetic conditions, such as Down syndrome and Ehlers-Danlos syndrome, have been associated with a higher incidence of keratoconus.

How is keratoconus diagnosed?

Keratoconus can be diagnosed through a comprehensive eye examination, which may include:

1-Visual acuity test: This measures how well you can see at various distances.

2-Refraction test: This determines your exact eyeglass prescription.

3-Slit-lamp exam: This is a microscope used to examine the cornea and other structures of the eye.

4-Keratometry: This measures the curvature of the cornea.

5-Corneal topography: This is a computer-assisted imaging technique that creates a detailed map of the cornea’s shape and curvature.

6-Pachymetry: This measures the thickness of the cornea.

7-Dilated eye exam: This allows the doctor to see the back of your eye.

Your eye doctor may also perform other tests to rule out other eye conditions or to confirm the diagnosis of keratoconus.

Can keratoconus damage vision?

Yes, keratoconus can damage vision. As the cornea becomes thinner and more cone-shaped, it can cause vision to become distorted, and blurry, and can lead to nearsightedness, astigmatism, and light sensitivity. In severe cases, the cornea may become scarred, causing even more visual impairment. If left untreated, keratoconus can lead to significant vision loss and may require a corneal transplant.

How is keratoconus treated?

The treatment of keratoconus depends on the severity of the condition. In mild cases, glasses or soft contact lenses may be sufficient to correct the vision. However, as the disease progresses, rigid gas-permeable contact lenses may be necessary to correct the vision. These lenses can help to reshape the cornea and improve vision.

In more advanced cases, surgery may be necessary. Some surgical options include:

1-Corneal cross-linking: This procedure involves using ultraviolet light and a special solution to strengthen the cornea and prevent further bulging.

2-Intacs: These are small, clear plastic inserts that are surgically placed into the cornea to help flatten it and improve vision.

3-Corneal transplant: This surgery involves replacing the damaged cornea with a healthy donor cornea.

It is important to note that keratoconus is a progressive condition, and the treatments may not be able to completely stop its progression. However, they can help to manage the symptoms and slow down the progression of the disease.

Does a patient with keratoconus need surgery?

Surgery is not always necessary for keratoconus, but it may be recommended in certain cases to improve vision. Some common surgical procedures for keratoconus include corneal cross-linking, implantable collamer lenses, corneal transplantation, and intracorneal ring segments. The choice of surgery depends on the severity of the keratoconus, the age of the patient, and other factors. It is important to discuss the benefits and risks of each procedure with a healthcare provider to determine the best course of action.