What is Keratoconus Disease? What are the symptoms and treatment methods?

Keratoconus is a progressive eye disease that affects the cornea, the clear front surface of the eye. It is characterized by the thinning and bulging of the cornea, resulting in a cone-like shape instead of the normal dome shape. This irregular shape causes distorted vision and can lead to significant visual impairment if left untreated.

The exact cause of keratoconus is still unknown, but it is believed to be a combination of genetic and environmental factors. It often starts during adolescence or early adulthood and progresses slowly over time. The disease may affect one or both eyes, with one eye usually being more severely affected than the other.

There are several symptoms associated with keratoconus, including:

1. Blurred or distorted vision: The irregular shape of the cornea causes light to scatter as it enters the eye, resulting in blurred or distorted vision. This can make it difficult to read, drive, or perform other daily activities that require clear vision.

2. Increased sensitivity to light: Many individuals with keratoconus experience increased sensitivity to light, known as photophobia. Bright lights, such as sunlight or headlights at night, can cause discomfort and glare.

3. Frequent changes in eyeglass or contact lens prescription: As the disease progresses, the shape of the cornea continues to change, requiring frequent changes in eyeglass or contact lens prescription to maintain clear vision.

4. Ghosting or double vision: Keratoconus can cause ghosting or double vision, where images appear to be duplicated or overlapping.

5. Eye irritation or redness: Some individuals with keratoconus may experience eye irritation, redness, or excessive tearing due to the irregular shape of the cornea.

Early detection and diagnosis of keratoconus are crucial for effective treatment. An eye care professional can perform various tests to evaluate the shape and thickness of the cornea, such as corneal topography or optical coherence tomography (OCT).

Treatment options for keratoconus depend on the severity of the disease and the individual’s specific needs. In the early stages, eyeglasses or soft contact lenses may be sufficient to correct vision. However, as the disease progresses, specialized contact lenses may be required to provide better vision.

1. Rigid gas permeable (RGP) contact lenses: RGP lenses are often the first choice for managing keratoconus. These lenses help to create a smooth, regular corneal surface, improving vision by compensating for the irregular shape of the cornea.

2. Scleral lenses: Scleral lenses are larger in diameter and vault over the entire cornea, resting on the white part of the eye (sclera). These lenses provide better comfort and stability for individuals with advanced keratoconus.

3. Hybrid lenses: Hybrid lenses combine a rigid center with a soft outer skirt, providing the clarity of RGP lenses and the comfort of soft lenses.

4. Piggybacking lenses: In some cases, two different types of contact lenses may be used together. This technique, known as piggybacking, involves placing a soft contact lens on the eye first, followed by an RGP lens on top.

In more severe cases of keratoconus, when contact lenses are no longer effective, surgical interventions may be considered. These include:

1. Corneal cross-linking (CXL): CXL is a minimally invasive procedure that involves applying riboflavin (vitamin B2) eye drops to the cornea, followed by exposure to ultraviolet light. This treatment helps to strengthen the cornea and slow down the progression of keratoconus.

2. Intacs: Intacs are small, crescent-shaped plastic inserts that are surgically placed within the cornea to flatten the cone shape and improve vision.

3. Corneal transplant: In severe cases where vision cannot be adequately corrected with contact lenses or other treatments, a corneal transplant may be necessary. During this procedure, the damaged cornea is replaced with a healthy donor cornea.

It is important for individuals with keratoconus to have regular follow-up appointments with their eye care professional to monitor the progression of the disease and adjust treatment as needed. With proper management, most individuals with keratoconus can achieve good vision and maintain their quality of life.