Keratoconus: Symptoms, Causes & Treatment | AccuVision

November 10, 2022

Keratoconus

Keratoconus is the progressive thinning and weakening of the corneal structure – the clear, transparent “windshield” of your eyes.

The corneal lamellar structure is a grid pattern, like a suspension bridge. As the cables of a bridge weaken at one end, the whole bridge tilts and changes shape.

Signs and symptoms.

If you experience:

Seeing a cloudy ‘halo’ around bright light
Progressively poor night vision
Finding yourself rubbing your eyes frequently to seek relief
Astigmatic element of your glasses prescription frequently changing
Sudden onset of blurred, distorted, or double vision when looking with just one eye

You may have early signs of keratoconus. Early detection helps prevent progression: book an appointment with a specialist eye care clinic to get your eyes checked.

What causes it?

The etiology of keratoconus is a mystery, but is thought to be mostly genetic and environmental, and made worse with habitual, vigorous, eye-rubbing from underlying allergies.

We estimate that 1 in 800 people suffer from keratoconus and one in ten of those, have parents with keratoconus. This varies vastly in different regions, ethnicities, and cultural backgrounds.

These factors may increase the chances of developing keratoconus:

Eye-rubbing

Intensive, repeated eye rubbing causes trauma to the cornea over time. It aggravates the condition and makes keratoconus progress faster.

Disorders

Certain disorders like Down syndrome, sleep apnea, and collagen diseases make the incidence of keratoconus more likely.

Family History

Parents with keratoconus should get their children’s eyes checked for signs from 10 years of age.

Age range

Keratoconus usually starts in teenage years but can show up earlier in childhood or adulthood.

Gender

Men are more likely than women to develop keratoconus.

Keratoconus treatment

There is no cure for keratoconus but there are several possible management options to eliminate its progression and improve quality of vision:

Corneal Collagen Cross-Linking

The aim is to stabilise the cornea and prevent the progression of keratoconus. This increases the stiffness and rigidity of the cornea and stabilise corneal thinning.

Topography Guided Corneal Profile Normalisation

We reshape the cornea to normalise it as much as possible, reducing distortion. With enough tissue, we also reduce the correction necessary from eyeglasses or contact lenses, opening up other possibilities like soft contact lenses. Corneal collagen cross-linking follows.

Contact Lenses

Hard lenses help improve visual acuity but can be fit improperly. Scleral, semi-scleral, hybrid, and customised specialist soft lenses are possible options too.

Intacs – Corneal Ring Segment Inserts

Segments of perspex, called Intacs, are inserted into the cornea to correct optical defects. They work by making the centre of the cornea flatter and more regular. Intacs, however, need to be combined with additional treatments for full visual correction.

A corneal transplant is the last option, where a small disc-sized area is removed from the diseased cornea. Then a new donor cornea, cut to fit, is placed in the opening.

For a condition with complex variations and underlying co-factors, a tailored care pathway, bespoke to every patient, is the most likely to result in a positive outcome.

People with keratoconus often find hard lenses ineffective and uncomfortable. This is why it’s so important to find experienced eye specialists who routinely handle complex contact lens fits and give every patient personalised care on long-term management.

With keratoconus, the two most important factors are timely care and expert screening to really improve the possibilities.

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