Keratoconus- Is it Treatable /Myth

- By Dr.Lomesh Patil
[MS, DNB, FICO, FCRS]
& M Kazi
[M.Optom, FLVPEI]

" November 10 " marks the launch of World Keratoconus Day, an annual day intended to raise awareness of this debilitating condition.
Keratoconus is a degenerative disorder characterised by thinning of the cornea, which is like the clear windscreen of the eye. The cornea, which is normally round or dome-shaped, starts to bulge and become cone-like instead. Given that the cornea is involved in bending (refracting) and focusing light rays onto the retina, this change leads to visual distortion, which can range from mild to severe depending on the stage of keratoconus.
Continuous or vigorous eye rubbing in susceptible individuals may lead to the development of keratoconus. For this reason, it is strongly recommended that eye rubbing be avoided. Read more about the dangers of rubbing your eyes.
Previous studies suggest that approximately 1 in every 2000 people has keratoconus, although recent work indicates the incidence is higher, perhaps as much as 1 in 50. Both sexes are affected equally. Most cases are diagnosed in younger people, between 15 to 30 years of age and both eyes are typically affected, although it is usually asymmetrical.
Symptoms
⦿ Sensitivity to light
⦿ Seeing 'halos'/ ghosting’
⦿ Distorted, blurry vision
⦿ Difficulty driving at night
⦿ Double vision in one eye or noticeably worse vision in one eye
⦿ Eye strain, eye pain
⦿ Headaches.

Treatment
⦿ Glasses or contact lenses to correct refractive error
⦿ Rigid contact lenses and hybrid contact lenses are particularly effective for keratoconus
⦿ Corneal rings to reshape the cornea
⦿ Collagen cross-linking to stabilise/strengthen the cornea – this is the only proven method to halt progression of the disease
⦿ Corneal transplant if all other treatment avenues have been exhausted.

Take Home Message

If you’ve been diagnosed with keratoconus, the 3 keys to a successful outcome are:
⦿ Early diagnosis
⦿ Referral for cross linking (if the disease is progressing)
⦿ A comfortable solution for your visual needs. This may be the right pair of glasses or one of a wide range of contact lens options.
Make sure you see an ophthalmologist (Corneal Specialist) who is highly experienced in keratoconus and sees this disease every day, not just once or twice a year.
They will have the latest technology to diagnose and manage your disease and they will keep up to date about new therapies and contact lens designs.
It is also important to realise that the vast majority of people do not need a corneal graft and actually do very well in contact lenses fitted by an expert.