09/11/2024
Keratoconus Day 10/11
Understanding Keratoconus: Symptoms, Treatments, and Contact Lens Options
Keratoconus is a progressive eye condition that affects the cornea, the transparent, dome-shaped surface that covers the front of the eye. This condition causes the cornea to thin and bulge outward, often taking on a cone-like shape, which leads to visual distortions. If left untreated, keratoconus can severely impact vision and quality of life, but with early diagnosis and proper treatment, individuals can manage the condition effectively.
What is Keratoconus?
Keratoconus (often abbreviated as "KC") is a non-inflammatory condition where the cornea progressively thins and weakens. This abnormal thinning leads to the cornea becoming more conical, distorting light as it enters the eye and causing blurry, distorted vision. The condition is typically bilateral, affecting both eyes, but one eye may be more severely affected than the other.
Symptoms of Keratoconus
The symptoms of keratoconus usually begin to manifest during the teenage years or early adulthood, though they can occur at any age. Common symptoms include:
Blurry or distorted vision: Even with glasses or regular contact lenses, vision remains unclear.
Frequent changes in prescription: People with keratoconus often experience rapid changes in their vision prescription.
Halos and glare: Especially noticeable at night, glare from lights and halos around streetlights can occur due to irregularities in the cornea.
Eye irritation: Some individuals experience sensitivity to light, itching, or general discomfort in the eyes.
Double vision: In some cases, the abnormal corneal shape can cause double vision, especially in the early stages.
Signs of Keratoconus
Signs of keratoconus are typically observed during an eye exam. Eye care professionals may notice:
Corneal thinning: The cornea will appear thinner in certain areas.
Irregular corneal shape: The cornea may appear more cone-shaped rather than its usual dome-like shape.
Scarring: In advanced cases, scarring can develop on the cornea due to the stretching and weakening of the tissue.
When Does Keratoconus Begin?
Keratoconus typically begins during the teenage years or in the early 20s, with most people experiencing the onset of symptoms by the age of 25. The condition progresses more rapidly in some individuals and can stabilize after several years in others. Early diagnosis and treatment are key to managing the condition effectively.
Treatments for Keratoconus
While there is no cure for keratoconus, several treatments can help manage symptoms and slow the progression of the disease.
Glasses and Contact Lenses: In the early stages of keratoconus, glasses or soft contact lenses may be enough to correct vision. As the condition progresses, specialized contact lenses become necessary.
Corneal Cross-Linking (CXL): One of the most important advancements in the treatment of keratoconus is corneal cross-linking (CXL). This minimally invasive procedure strengthens the corneal tissue by using ultraviolet (UV) light combined with riboflavin (vitamin B2). The process creates bonds between collagen fibers in the cornea, helping to halt or slow the progression of the condition and sometimes improve vision. Cross-linking is particularly effective when the cornea is still relatively healthy and before it becomes too scarred or severely thinned.
Intacs (Corneal Inserts): These small, plastic inserts are placed into the cornea to reshape it and improve vision. They are typically used for moderate keratoconus cases and can sometimes reduce the need for a corneal transplant.
Corneal Transplant: In advanced cases where vision cannot be corrected with lenses or other treatments, a corneal transplant (keratoplasty) may be required. This involves replacing the damaged cornea with a healthy donor cornea.
Contact Lens Options for Keratoconus
For individuals with keratoconus, contact lenses are often the best solution to improve vision. However, traditional soft contact lenses often don’t work well for people with this condition due to the irregular shape of the cornea. Instead, there are several specialized contact lens options designed to provide better comfort and vision for keratoconus patients:
Rigid Gas Permeable (RGP) Lenses: RGP lenses are smaller than soft lenses and rest on the cornea, providing a smooth surface that compensates for the irregularities caused by the condition. While they can be uncomfortable at first, RGP lenses offer excellent visual clarity.
Hybrid Lenses: The principle of these lenses is to combine the comfort of a soft lens with the visual benefits of a rigid gas permeable lens. The central part of the lens is made from a rigid material to help improve vision, while the outer edges are made of a softer material for increased comfort.
Scleral Lenses: Scleral lenses are often the best option for individuals with advanced keratoconus. These are large-diameter, gas permeable lenses that vault over the entire cornea and rest on the white part of the eye (the sclera). Scleral lenses provide several benefits:
Superior Comfort: Because they don’t touch the irregular corneal surface, scleral lenses offer greater comfort than other types of contact lenses.
Improved Vision: By creating a smooth surface over the cornea, scleral lenses can provide exceptional visual clarity, even for people with severe keratoconus.
Protection: The lens creates a cushion of saline solution between the lens and the cornea, helping to protect the cornea from further irritation or dryness.
Custom Fit: Scleral lenses are custom-made to fit each individual’s eye, making them ideal for people with irregular corneas.
Piggyback Lenses: This method involves wearing a soft contact lens under an RGP lens for added comfort and stability. Piggyback lenses can be used for patients who find RGP lenses too uncomfortable on their own.
Conclusion
Keratoconus can be a challenging condition, but with early diagnosis and appropriate treatment, individuals can maintain good vision and improve their quality of life. Corneal cross-linking (CXL) is a groundbreaking treatment that can stop the progression of keratoconus, while specialized contact lens options, especially scleral lenses, can offer superior vision correction and comfort.
If you or someone you know is experiencing symptoms of keratoconus, it's important to consult an eye care professional for a proper diagnosis and personalized treatment plan. With the right care, most people with keratoconus can continue to lead active, fulfilling lives.
