How to Treat Keratoconus – Treatment options for Keratoconus
As discussed in our previous blog post, keratoconus is a corneal eye disease that is progressive in nature can significantly impact your visual acuity. Risk factors are both environmental and genetic in nature, and can include atopy, allergic eye disease, eye rubbing, a family history of the condition, and more. Early diagnosis and intervention of the condition by your eye doctor is critical to minimize the likelihood of progression and to maximize optimal vision over the lifetime. The condition of keratoconus and its associated signs typically starts to manifest in the teenage years, but symptoms sometimes do not present until later in life. People with keratoconus may find that their glasses prescription frequently changes and that their vision is still blurry, and that they’re still experiencing glare and halos even with the updated prescription. The good news is that there are specialty contact lenses and surgical options that are able to correct vision in individuals with keratoconus in ways that glasses can not.
Can Keratoconus be Treated?
The good news for anyone who might have keratoconus or is at risk of developing keratoconus is that there are multiple treatment strategies that are now available to individuals. Prevention strategies include mitigating environmental factors that may increase risk of eye rubbing. A minimally invasive procedure called Corneal Cross Linking is available to significantly decrease the likelihood of progression through means of strengthening the cornea. Advanced states of the corneal condition have multiple surgical options to improve corneal health and function. Glasses unfortunately do not always have the best ability to correct vision for keratoconus. For corneas with the disease that have been shown to be stable, there are refractive options, aside from glasses, that can correct vision to a much higher degree – the best option often being scleral contact lenses. Our own Dr Petar Prpic recently completed additional training and obtained his FSLS (Fellow of the Scleral Lens Society) and is one of only a few practitioners in BC listed on the FSLS website as a “scleral lens specialist”.
Goals of Keratoconus treatment?
The main intent of keratoconus treatment is twofold. The first priority is to reduce progression of the condition and its affects on the ocular and corneal health. The second goal of treatment is to maximize an individuals visual potential.
How to prevent Keratoconus?
Can I stop Keratoconus?
The best plan for someone who may one develop keratoconus is early diagnosis and intervention, and the knowledge of how to treat keratoconus. Talk to your eye doctor if you have any concerns or risk factors that may increase the likelihood of developing the condition. Additional testing such as corneal topography or anterior segment OCT can help with diagnosis before symptoms even occur. Make sure any systemic allergic conditions are managed with your family physician and make sure eye rubbing is minimized.
What is Corneal Crosslinking?
Corneal crosslinking is a procedure performed by a corneal specialist that is considered minimally invasive that is performed once the condition has been diagnosed and shown to be progressing. The point of the procedure is to strengthen the cornea so that it is less likely to bulge, deform, and become ectatic. The procedure uses an ophthalmic solution containing riboflavin which is used to absorb light and cause a chemical change in the cornea once exposed to UV light with ideal wave length of approximately 370nm. The chemical change that occurs in the cornea results in the college fibres in the eye to strengthen so that its more resistant to changes from the disease
How to Treat Keratoconus??
Can Glasses Correct Keratoconus?
The first line of visual correction for most individuals with only early signs and symptoms of keratoconus are still glasses. There is however, unfortunately a limit to how well glasses can correct vision in an eye with keratoconus. The reason that glasses can only correct vision to a limited degree is due to high degrees of Irregular Astigmatism and high-order aberrations.
Can Contact Lenses Correct Keratoconus?
Contact lenses are able to be made with larger powers of astigmatism, and they are also able to treat irregular astigmatism and high order aberrations in eyes in ways that glasses can not. Traditional soft contact lenses unfortunately are not the most affective for keratoconus treatment, fortunately there are multiple other contact lens options that can be used.
What Types of Contact Lenses are used for Keratoconus?
Rigid Gas Permeable (RGP) lenses and Scleral Contact Lenses
Both RGPs and scleral contact lenses are hard contact lenses that are able to vault the cornea (and any irregularities) and subsequently mask the imperfections that may exist. RGPs have been around for many years and are smaller in diameter and sit directly on the cornea. Scleral contact lenses have a much larger diameter and sit on the sclera (the white part of the eye). Both contact lenses allow for a layer of fluid to exist between the contact lens and the cornea which allow for improved optics and with sclerals, for nourishment and hydration of the cornea. Keep your eyes peeled for a future blog post on scleral contact lenses!
Can Surgery Correct Keratoconus?
Very advanced stages of keratoconus can cause scarring, eye pain, further vision loss, and permanent corneal damage. When the keratoconus is extremely advanced, prevention and use of optical correction through contact lenses may not be an adequate option. In some individuals and eyes, surgical intervention is warranted to repair the cornea. Surgical options typically include either partial-thickness (Deep Anterior Lamellar Keratoplasty) or full-thickness (Penetrating keratoplasty) corneal transplants, where the patients cornea is either replace by or grafted with a donor cornea. The purpose of surgical intervention such as corneal transplants is to replace a sick cornea with a healthy donor cornea.
How to Treat Keratoconus – conclusion
Keratoconus is a progressive corneal ectasia that can have profound impacts on an individual’s visual function and quality of life. Early detection, and subsequent early intervention is vital for the proactive care essential to maintain long term visual function. The ultimate goal of early intervention in eyes with keratoconus is to reduce the likelihood of progression with the use of corneal cross linking. Once the condition has progressed enough to affect the corneal integrity and health, specialty contact lenses are the best way to optimize your vision. If the condition of keratoconus progresses further, surgical intervention may be warranted to replace a sick cornea with a healthy one.
Hopefully this article was able to answer some questions you may have had about how to treat keratoconus, as well as some options to maximize your vision. Early intervention is the best proactive approach to optimal long term visual function. If you or someone you know has concerns for keratoconus, please feel free to come on in for a consultation. For more information, visit Prpic Eyecare Centre and see how their services can help you optimize you ocular health and preserve your vision, call 604-337-2575 or email us at info@prpiceyecare.com
