Keratoconus

Understanding Keratoconus

What exactly is keratoconus? Imagine looking through a window that gradually changes shape, distorting everything you see. Keratoconus is much like this. It’s a progressive eye disease where the cornea – the clear, dome-shaped surface at the front of the eye – thins and starts to bulge outwards into a cone shape. This transformation from a smooth dome to an irregular cone can severely affect your vision.

The causes of keratoconus can be varied. Genetic factors play a significant role. If you have a family history of this condition, you might be at higher risk. It is often linked to a deficiency in collagen, a protein that helps maintain the cornea’s shape. Behavioural factors are also crucial. Rubbing your eyes vigorously or improperly using contact lenses can lead to trauma, increasing your risk.

Environmental factors, such as hay fever and excessive exposure to UV light and air pollution, can damage the cornea over time. Additionally, people living in certain geographic regions with harsh climatic conditions might be more susceptible. Lastly, keratoconus is often associated with health conditions such as asthma, eczema, Down syndrome, and other eye diseases such as glaucoma and retinitis pigmentosa.

At Ezekiel Eyes we see many keratoconus patients who suffer from hay fever and rub their eyes vigorously. This extreme and excessive eye rubbing will cause the cone to become more distorted and cause a further deterioration in the patient’s vision.

Symptoms of Keratoconus

How do you know if you might have keratoconus? It often starts subtly, so it can be tricky to pinpoint early on. Early symptoms include blurring and distortion of vision. You might notice that your vision is increasingly fuzzy or that straight lines appear wavy. Sensitivity to light and glare can also be an early indicator. You may find it difficult to drive at night due to the glare or halos from headlights and streetlights. Eye irritation and strain, along with frequent headaches, can further signal the onset of keratoconus. Night vision difficulties are common, making it hard to see clearly in low-light conditions.

As the disease progresses, symptoms become more pronounced. Visual distortions increase, and you might start seeing halos or glowing rings around lights. This can be particularly bothersome when looking at bright lights or screens. Rapidly worsening near-sightedness or astigmatism is another sign. You may find yourself needing to update your prescription glasses or soft contact lenses more frequently. Lastly, as the cornea becomes more cone-shaped, soft contact lenses might become uncomfortable to wear, leading to increased discomfort.

Recognising these symptoms early can make a significant difference in managing the condition effectively.

Watch the following video to get answers to many frequently asked questions about keratoconus.

Diagnosis of Keratoconus

How is keratoconus diagnosed? The process typically begins with a comprehensive eye examination. Your medical and family history is crucial, as genetic factors can play a significant role. Initial visual acuity tests help assess how well you can see at various distances.

Advanced diagnostic tools provide a detailed picture of your cornea’s condition. Keratometry measures the curvature of the cornea, highlighting any abnormalities. Corneal topography creates a precise map of the cornea’s surface, identifying irregularities in shape and thickness. Corneal pachymetry measures the thickness of the cornea using a pachymeter, essential for detecting thinning areas.

Additional examinations like retinoscopy can reveal irregularities, while a slit-lamp examination allows for a detailed evaluation of the cornea’s structure. These tests collectively ensure an accurate diagnosis, helping to tailor the most effective treatment plan.

Watch the following video by Dr Joseph Allen where he explains some of the diagnostic tests that can be performed to understand more about your keratoconus condition.

Treatment Options for Keratoconus

What are the treatment options for keratoconus? Fortunately, there are several effective ways to manage this condition, depending on its severity. Non-surgical treatments are often the first line of defence. In the early stages, prescription glasses can help correct vision. Custom soft contact lenses are designed to fit the irregular shape of the cornea, offering comfort and better visual clarity for mild to moderate cases. Gas permeable contact lenses provide more rigid correction, improving vision by covering the cone-shaped cornea with a smooth, regular surface. For advanced cases, hybrid and scleral contact lenses combine the best of both worlds, offering stability and comfort.

Corneal crosslinking (CXL) is a non-surgical procedure that uses UV light and riboflavin to strengthen the cornea. This treatment can halt the progression of keratoconus, with two types available: epithelium-off, which involves removing the outer layer of the cornea, and epithelium-on, which leaves it intact.

Surgical options include Intacs, micro-thin inserts that flatten the cornea and can be adjusted or removed as needed. In severe cases, a corneal transplant may be necessary, where the damaged cornea is replaced with donor tissue.

Topography-guided conductive keratoplasty uses radio waves to reshape the cornea, helping improve near-sightedness.

Watch the following to learn more about how scleral contact lenses can often be a great solution for people suffering from keratoconus.

Managing Keratoconus

How do you manage keratoconus effectively? Regular monitoring is essential. Frequent eye exams help track the progression of the disease and allow for timely adjustments to your treatment plan. Early detection and consistent follow-ups can make a significant difference in managing keratoconus.

Lifestyle adjustments play a crucial role too. Avoiding eye rubbing is paramount, as this can exacerbate the condition. Managing allergies effectively can also help reduce the urge to rub your eyes. Protecting your eyes from UV exposure is another key factor. Wearing sunglasses with UV protection whenever you are outdoors can help safeguard your corneas from further damage.

Additionally, maintaining good eye hygiene, especially if you wear contact lenses, is vital. Ensure your lenses are cleaned properly and replaced as recommended by your optometrist. Staying informed about the latest treatments and advancements in keratoconus care can also be beneficial.

Living with keratoconus requires vigilance and proactive care, but with the right strategies, you can maintain good vision and quality of life.

Living with Keratoconus

How does keratoconus impact daily life? The challenges can vary from mild inconveniences to significant disruptions. Daily activities like reading, driving, and using digital devices may become difficult due to distorted vision and increased sensitivity to light. It’s important to find ways to adapt and manage these difficulties. For instance, using brighter lighting when reading or working on a computer can help reduce eye strain. Anti-glare screens and specialised eyewear can also make a big difference.

Support and resources are crucial. Having a network of understanding family, friends, and healthcare professionals can provide the emotional and practical support needed to cope with the condition. Professional follow-ups ensure that your treatment plan remains effective and any changes in your condition are promptly addressed.

Educational resources for both patients and their families can empower you to manage keratoconus better. Understanding the condition helps in making informed decisions about treatments and lifestyle adjustments. It’s also comforting to know that many people with keratoconus lead normal, fulfilling lives with the right management strategies.

Managing keratoconus involves a balance of medical care, lifestyle adjustments, and emotional support.