If you’re reading this, there’s a good chance you or someone you know has been diagnosed with keratoconus. Keratoconus is a progressive eye disease that affects vision and can damage the eye. It occurs when the cornea (the clear front part of your eye) becomes thin and starts to bulge outwards. This can cause blurry vision and other problems. There are many risk factors that are thought to contribute to the likelihood of developing the condition. Luckily, if diagnosed early enough, there are management options that can be performed to reduce the likelihood of progression. Individuals with keratoconus have multiple ways to maximize their vision including specialty contact lenses and surgical interventions.
Everything You Need to Know About Keratoconus?
What Is Keratoconus?
Keratoconus is a disorder of the eye that causes the cornea to thin and bulge. This can lead to vision problems and even blindness in some cases. Symptoms of keratoconus include blurry vision, difficulty seeing at night, sensitivity to light and glare, and drastic or sudden changes in your glasses prescription. Treatment for keratoconus varies depending on the severity of the condition, but may include corrective eyeglasses, contact lenses, or surgeries that can treat and/or prevent progression of the condition
Keratoconus typically begins in adolescence or young adulthood, and progresses slowly over time. In most cases, both eyes are affected to some degree, though one may be more severely affected than the other. The condition is relatively rare, affecting about 1 in 2,000 people; however, it is thought by many keratoconus experts to be extremely underdiagnosed.
There is no known cure for keratoconus, but treatments can help manage the symptoms and slow the progression of the condition. In mild cases, corrective eyeglasses or contact lenses may be all that is needed. More severe cases may require surgery to improve vision.
If you suspect you or a loved one may have keratoconus, it is important to see an eye doctor for a comprehensive eye exam to ensure early diagnosis and intervention.
What Causes Keratoconus and What are Risk Factors for Keratoconus?
The cause of keratoconus is a combination of genetic and environmental factors. Some risk factors for keratoconus include a family history of the condition, exposure to ultraviolet light, chronic eye rubbing, and atopy. Keratoconus typically begins in late adolescence or early adulthood, and may progress gradually or rapidly. In some cases, the condition stabilizes on its own; however, in other cases it progresses to the point where vision is severely impaired and may even lead to blindness. There is no cure for keratoconus, but there are treatments available to help manage the condition and improve vision.
Corrective eyeglasses or contact lenses are often the first line of treatment for keratoconus. In some cases, however, surgery may be necessary to improve vision. Surgery for keratoconus typically involves transplanting healthy corneal tissue from a donor into the eye. This procedure is known as a corneal transplant. Keratoconus can be a progressive and debilitating condition, but with proper treatment and early intervention, most people with the condition can maintain functional vision.
What are Symptoms of Keratoconus?
Symptoms of keratoconus can vary from person to person, and even from day to day for the same person. Generally, symptoms include blurry vision, difficulty seeing at night, sensitivity to light and glare, and changes in prescription eyeglasses. In some cases, the condition progresses rapidly, leading to blindness. However, with proper treatment, most people with keratoconus can maintain good vision or even improve their vision.
How to Detect Keratoconus?
Keratoconus is detected by evaluating your risk factors (ex: genetics through family history and ocular allergy with eye rubbing), glasses prescription, and assessing your ocular health. Thorough assessment of the cornea under a slit lamp microscope, along with assessment of the curvature of your cornea helps with diagnosis.
In mild or early cases it can be difficult to determine if keratoconus is present. Sometimes we need to wait until we see progression or change of someone’s glasses prescription and/or corneal curvature before we are able to confirm a diagnosis.
The utilization of newer technologies such as Ocular Coherence Tomography (OCT) and Corneal Topography can help aid the detection and diagnosis of keratoconus, especially in early and mild cases.
Does an Eye Exam Detect Keratoconus?
Keratoconus is typically diagnosed through a comprehensive eye exam. During the exam, the doctor will examine the eyes for signs of keratoconus, such as thinning of the cornea and bulging of the cornea. The doctor may also use special equipment such as a slit lamp or pachymeter to measure the thickness of the cornea and the curvature of the cornea, respectively. If keratoconus is suspected, further testing may be done to confirm the diagnosis.
There are a number of treatments available for keratoconus, depending on the severity of the condition. In mild cases, corrective eyeglasses or contact lenses may be all that is needed. In more severe cases, surgery may be necessary to improve vision. Surgery for keratoconus typically involves transplanting healthy corneal tissue from a donor into the eye. This procedure is known as a corneal transplant. Keratoconus can be a progressive and debilitating condition, but with proper treatment, most people can have functional vision over the course of their lives
Is There Equipment Used to Diagnose Keratoconus?
There are a number of pieces of equipment that can be used to diagnose keratoconus. One of the most common pieces of equipment is a slit lamp. A slit lamp is a special microscope that uses a narrow beam of light to examine the eyes. This microscope can be used to measure the thickness of the cornea and the curvature of the cornea.
Advanced diagnostics include anterior segment optical coherence tomography (OCT) and topography. Both of which we have on site at Prpic Eyecare Centre.
Are there optometrists who have received additional training for keratoconus?
As you will read about later in this post (and in the upcoming next blog post), one of the best treatment options for achieving the best possible vision in eyes with keratoconus is the use of contact lenses – and the best contact lenses for this are scleral contact lenses. Your optometrist is able to obtain additional training and receive their “Fellowship of the Scleral Lens Society” (FSLS). Dr Petar Prpic is one of only several hundred eye doctors in North America with the designation, and one of only a handful in Canada.
How Do You Treat Keratoconus?
Treatment of keratoconus is multifactorial with many options depending on the stage and the severity of the condition. We at Prpic Eyecare Centre strongly believe in proactive care, and that is no different when it comes to keratoconus. The earlier you intervene with keratoconus, the more likely you are to maintain optimal vision throughout your lifetime. Treatment options include: mitigating risk factors and minimizing progression, glasses, surgical interventions, and maximizing visual potential with contact lenses.
Are glasses an option?
For early stages of keratoconus, glasses are still sometimes a viable option. Even though some individuals with keratoconus are able to sometimes achieve 20/20 vision (read more about this in our previous post), they still sometime unfortunately with bad symptoms of glare, ghosting of images, and double vision. The good news – Contact lenses are able to correct vision to a degree that is significantly better than glasses in individuals with keratoconus.
Are There Surgeries for Keratoconus?
There are two types of surgeries that can be done for keratoconus. The first type is performed to prevent progression or worsening of the disease. The second type is performed to aid in visual improvement.
Corneal Crosslinking is the main surgical intervention that is performed to prevent the progression of keratoconus. This procedure is most beneficial when performed early on in the diagnosis/detection of keratoconus. It involves a surgical procedure where a combination of Riboflavin and UV light is used to strengthen cornea and prevent further progression. It is important to note that Corneal Crosslinking surgery does not usually lead to an improvement in your visual acuity.
There are multiple different surgeries that can be performed to try to improve vision if you have been diagnosed with Keratoconus. These include topography-guided PRK (photorefractive keratectomy), intracorneal ring segments, and corneal transplantation. Whether or not you would be a candidate for any of these surgeries, and what their expected outcome would be, depends on each individuals case or keratoconus.
Can I Correct Keratoconus with Contact Lenses?
Many cases of keratoconus can benefit from contact lens wear, especially specialty contact lenses. Specialty contact lenses can include corneal gas permeable (GP) lenses, piggyback lenses, custom soft lenses, hybrid contact lenses, and scleral lenses. The goal of fitting these lenses in keratoconus patients is to improve the visual acuity relative to glasses or traditional contact lenses.
As keratoconus progresses, it leads to an irregular corneal surface which limits the visual acuity in glasses and traditional contact lenses. Specialty contact lenses can correct for this corneal irregularity and help with symptoms of blurry vision, difficulty seeing at night, sensitivity to light and glare.
A comprehensive examination and discussion of your specific case will determine which specialty lens option would be the best for you.
What is Keratoconus? – Conclusion
There are a number of treatments available for keratoconus, depending on the severity of the condition. In mild cases, corrective eyeglasses or contact lenses may be all that is needed. In more severe cases, surgery or specialized contact lenses may be necessary to improve vision. Surgery for keratoconus typically involves transplanting healthy corneal tissue from a donor into the eye. This procedure is known as a corneal transplant. Keratoconus can be a progressive and debilitating condition, but with proper treatment, most people with the condition can maintain good vision or even improve their vision.
I hope this article has given you some knowledge on keratoconus. As with many conditions, the earlier you intervene, the better off you and your loved ones will be. 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
