Why Is Diagnosis Of Keratoconus So Important? – Interview With Jayden

Here is another excerpt from Jayden’s interview for our YouTube channel — this time on keratoconus — a condition many patients have never heard of until the day they’re diagnosed with it.

Jayden walks through what’s actually happening to the eye, why picking it up early matters so much, and what treatment looks like when the condition is progressing.

If you (or someone in your family) has been told you have keratoconus, or you’re just curious about the condition, this article is for you.

Key Takeaways

• Keratoconus is the gradual thinning and bulging of the cornea, which distorts how light enters the eye.
• Early diagnosis matters because it gives us a baseline to compare against — without it, we can’t tell if the condition is progressing.
• Progression can potentially be slowed with corneal collagen cross-linking, performed by an ophthalmologist.
• Avoiding eye rubbing is one of the most important things a patient with keratoconus can do.
• Cross-linking aims to slow progression, not reverse the condition or remove the need for vision correction.

What Is Keratoconus, Actually?

“Basically, the front surface of your eye is called the cornea, and the cornea acts like a smooth window that allows us to see clearly.” — Jayden Simpson, Optometrist

A lot of patients we diagnose with keratoconus tell us the same thing — they’d never heard the word before their appointment. We see plenty of it at Ezekiel Eyes, but it’s just not something that comes up in everyday conversation the way short-sightedness or astigmatism does.

The cornea is the clear surface at the very front of the eye, and normally it’s a smooth, regular curved shape. In keratoconus, that surface gradually thins and weakens in one area, and as it weakens it starts to bulge forward slightly. That change in shape alters the way light passes through the eye, which is what causes the blurred or distorted vision, and sometimes halos around lights at night, that patients describe.

One analogy that’s stuck with us is a worn tyre with a weak spot — that’s the point where it starts to bulge outward, simply because it’s structurally weaker than the rest of the surface around it. It’s a useful way to picture what’s actually happening on the front of the eye.

Why Does Catching Keratoconus Early Make Such A Difference?

“The main thing why early diagnosis is important, because firstly, we can establish a baseline measurement.” — Jayden Simpson, Optometrist

Keratoconus doesn’t progress the same way in every patient, and it’s genuinely difficult to predict who’s going to see rapid change versus who’ll stay fairly stable. That unpredictability is exactly why the timing of diagnosis matters so much.

The first reason comes down to measurement. When we diagnose someone, we take a detailed picture of what their cornea looks like at that point in time — that’s the baseline (a corneal topography map). At a six month review and we can compare the two sets of measurements directly.

The second reason is behavioural. Patients with keratoconus are consistently told the same thing — avoid rubbing your eyes. Eye rubbing is strongly linked to progression, and a lot of that urge to rub comes from underlying allergies that haven’t been properly managed.

What Happens If The Condition Is Progressing?

“That’s why baseline is so important, because the first thing we send through to the ophthalmologist when we refer them on is we send them the patients data.” — Jayden Simpson, Optometrist

If the measurements show the cornea is changing over time, the next step is usually a referral to an ophthalmologist for a treatment called corneal collagen cross-linking. This isn’t something we do in our own clinic — it’s a clinical procedure carried out by an ophthalmic surgeon, and we refer patients on for it.

Before an ophthalmologist will take on a case for cross-linking, they generally want to see documented evidence that the keratoconus is actually progressing, which again comes back to why that baseline data matters so much. It’s the first thing we send through with the referral.

The procedure itself involves applying vitamin B2 drops to the eye, followed by controlled UV light. Together, these strengthen the bonds within the corneal tissue, and the stronger those bonds are, the more resistant the cornea becomes to further bulging.

It’s important to be clear about what cross-linking does and doesn’t do — it isn’t designed to reverse keratoconus, and it doesn’t remove the need for glasses or contact lenses afterward. What it aims to do is slow the progression down.

Final Thoughts

The theme running through all of this is the same one that comes up with a lot of eye conditions — you can’t manage what you haven’t measured. Keratoconus can be unpredictable, but a baseline taken early gives us the ability to actually track what’s happening rather than guess at it, and that’s the difference between catching progression in time to act on it and only noticing once vision has already changed irreversibly.

If you’ve been told you or a family member might have keratoconus, or you’ve noticed symptoms like blurred vision, distorted vision or halos at night, don’t wait to get it looked at properly. The best decision you can make is to book a consultation with us at Ezekiel Eyes.

Scheduling an appointment with us is straightforward and hassle-free. Simply give us a call at (08) 9386 3620, and our friendly staff will be happy to assist you in booking a convenient time for your consultation. Alternatively, you can click the “Request an Appointment”

YOUTUBE TRANSCRIPT

It’s a great question, and we, we see a lot of patients that have keratoconus at Ezekiel Eyes.

0:15

We also diagnose a lot of patients with keratoconus for the first time, and when we have the conversation with these patients, a lot of the time what they say is they’d never heard of keratoconus.

0:25

Before diagnosis. Now, as far as what keratoconus is, I think it’s important to go into some of the anatomy behind it.

0:34

So to put it simply, I’ll keep it quite brief, basically the front of your eye you have something called the cornea, and basically the cornea almost acts like a smooth window that allows us to see clearly.

0:47

Now normally this smooth window is nice and regularly shaped and there’s no bumps in it, there’s no notches, it’s a nice spherical shape all the way along.

0:58

Now what happens in keratoconus is this smooth window starts to become thinner over time, it starts to become a little bit weaker

1:07

over time, and what happens with that thinning and weakening of the cornea is you get this small sort of protrusion or bulging,

1:15

and this protrusion and bulging changes the shape of the front of the eye which changes the way that light interacts with the front of the eye,

1:23

and it can scatter light and cause things such as distorted vision or blurriness, or you might get halos at night.

1:31

So to put it simply, it’s the thinning and bulging of the front surface of the eye which causes an irregular surface.

1:39

Now, as far as why early diagnosis is so important is because sometimes this condition can progress over time.

1:48

It’s difficult to predict, truth be told, but the, the main thing why early diagnosis is important, because firstly, we can establish baseline measurements.

1:59

So basically, we get a good picture in time at this date of what the patient’s cornea is looking like.

2:05

We can then get the patient back at another point in time, and we can compare those two consecutive measurements, and we can see whether or not there’s progression.

2:15

Now, if there is progression, then there is treatment options available to slow down that progression. It’s something called corneal collagen cross-linking.

2:25

We can’t determine basically if there is progression if we don’t have a baseline measurement. So super, super important.

2:31

The other thing that makes early diagnosis important is there’s behavioral modifications which we can go through with the patient to try and also stop the condition from getting worse.

2:43

If you speak to anyone with keratoconus, the first thing they’ll tell you is it’s really, really important that they don’t rub their eyes.

2:50

So the earlier we pick it up, the earlier we can counsel the patient, the earlier we can get on control, under control allergies that might make them want to rub, and the better the outcomes are as well for those patients.

3:03

So the way, the way it’s been described to me is if you think of the cornea as kind of like a soccer ball, which is

3:11

topical now because the World Cup’s on, but if you think of it as a soccer ball, patients with keratoconus, it’s more like the pointy end of a rugby ball or an AFL ball. Is that right?

3:21

Is that close? Yeah, spot on.

3:23

Another really good analogy is if you have a worn tire and it has a weak spot in it, at that weak spot it will start to bulge.

3:30

So basically what’s happening is at that area in the cornea, it’s quite thin, so it’s bulging forward because it is structurally weaker than the rest of the cornea.

3:41

But you’re spot on there, that’s a good analogy. And, um, so, and so corneal cross-linking is something that an ophthalmic surgeon would do, and, and you would refer the patient in, in that case, is that right?

3:53

Yes, exactly.

3:53

So in order to see an ophthalmologist for corneal collagen cross-linking, in most cases what they will want to see is that the patient has demonstrated accelerated progression.

4:04

So again, that’s why baseline is so important, because the first thing we send through to the ophthalmologist when we refer them on is we send them their data,

4:13

and the first thing they’re going to look for in the data is that this keratoconus is getting worse or it’s progressing.

4:18

And it— if it is progressing, then that’s a pretty good indication that if we perform this corneal collagen cross-linking, then it has the potential to slow down this progression.

4:29

To go into corneal collagen cross-linking a little bit, basically what it involves is there’s a sort of vitamin drop.

4:38

It’s vitamin B2, to be specific.

4:41

The patient will have these vitamin B2 drops placed onto their eye, and then what the ophthalmologist will do is they’ll apply some controlled UV light.

4:51

And the purpose of both of these acting together is basically it strengthens the bonds between that corneal tissue.

4:57

So the stronger the bonds between the front of the eye are, the harder it is for progression to occur because they’re connected to one another more strongly.

5:08

So that’s really, really good for slowing down the progression. The big thing is it’s not intended to reverse keratoconus.

5:17

It doesn’t tend to reverse the need for vision correction, but the goal of the cross-linking is to slow down. The progression.

5:26

But outcomes are generally quite good. It does a good job.

5:30

But again, you need that baseline and you need that evidence of progression to ensure it’s going to be worthwhile to send the patient off for that.