Keratoconus: Learn everything there is to know about the eye condition in which the cornea thins and bends

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Keratoconus is a corneal degenerative condition in which the cornea weakens over time. “It continues to narrow and steepen (bend), producing visual difficulties but not blindness,” Dr Sridevi Haldar, Ophthalmologist/Eye Surgeon, Ortho Vision Clinic, Noida, explained.

Eye screenings are required for those above the age of 30.
The doctor went on to say that, as the name suggests, Keratoconus causes the spherical cornea to become conical in shape, hence the name keratoconus – (kerato -meaning cornea and conus-meaning conical). “The light beam is focused into the retina by the clear translucent cornea.” “Any visual distortions are caused by any abnormality in its shape,” she explained.

What is the cause of keratoconus?

It usually begins in adolescence and lasts until 35-40 years of age. Although a variety of risk factors have been found, researchers have not been able to pinpoint the actual cause of the condition.

Childhood eye allergies, such as VKC (vernal keratoconjunctivitis), vigorous eye rubbing, long-term usage of steroid eye drops, and hereditary components are all major risk factors.

“These patterns cause progressive corneal steepening or bending, as well as central corneal thinning and sudden rupture of Bowman’s membrane layer.” “Acute hydrops results, leaving a central corneal scar that dramatically reduces vision,” she told indianexpress.com.

Symptoms

For early detection of this condition, any cylindrical power >1.25D should be extensively investigated.

Keratoconus is a condition in which a person’s eyesight is constantly changing and they are not satisfied with the quality of their vision.

Keratoconus can also be identified by an increase in cylindrical power.

Hormonal factors might sometimes cause sudden blurring of vision during pregnancy. Keratoconus can develop as a result of this.

Treatment

“The treatment of keratoconus is determined by the disease’s stage. “The refractive error can be addressed with glasses in the early stages of keratoconus, but vision may not be particularly clear with them in the advanced stages,” stated Dr. Haldar.

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That’s when rigid/hard contact lenses, she says, might be required. These lenses come in a variety of shapes and sizes, depending on how steeply the cornea is slanted:

• RGP (Rapid Growth Plan) (rigid gas permeable lenses)

• Miniscleral lenses are a type of scleral lens that is used

• Rose-colored contact lenses

• Scleral lenses are a type of contact lens.

Cross-linking of collagen in the cornea (C3R)

• Corneal cross-linking is a treatment that can be used in mild-moderate keratoconus instances with documented progression over the course of a year (increase in steepening by 1D)

• This entails priming the cornea with Riboflavin eyedrops for 20-30 minutes, followed by UVA radiation beam exposure for 10-30 minutes to reinforce and strengthen the cornea and prevent it from further bending.

Intacs/ICRS

• Intacs or intracorneal segments are put in the cornea to regularise the form of advanced asymmetric cones (as indicated on corneal topography) so that contact lenses fit better and vision quality is improved. They do not totally repair the refractive problem, but rather alter the shape of the cornea.

• In advanced keratoconus, such as post hydrops scarring, when the Bowman’s membrane layer of the cornea has burst due to excessive corneal thinning, leaving a scar in the centre of the cornea, obstructing the visual axis.

• Cornea surgeons can use a partial thickness or full-thickness corneal graft to replace a damaged cornea with a donor’s transparent cornea.

• The donor corneal graft is sutured to the host corneal rim using 16-20 fine sutures, which are withdrawn after 8-9 months until the donor cornea is completely integrated with the host rim. After a week, though, one can begin conducting ordinary tasks.

These are the best keratoconus treatments now accessible, with a few tweaks to each procedure to improve our patients’ visual outcomes.