Keratoconus Treatment

SAVE YOUR SIGHT FOR THE FUTURE

What Happens In Keratoconus

The cornea is the front part of the eye lens, made of collagen fibers, which makes the light fall onto the retina. In a keratoconus eye, the layers of the cornea start thinning out, moreso in the central area. This thinning out causes the cornea to become weak and change its shape from a dome-like structure to a cone-like structure which leads to induction of high astigmatism.

This thinning also causes the cornea of the keratoconus eye to become irregular in shape which in turn prevents all the light rays entering our eyes to focus accurately onto the retina. These two factors cause a drop in the patient's vision.

At late stages of the disease, the cornea becomes extremely thin and is unable to withstand the pressure from within the eyes. This leads to small tears in the cornea and accumulation of fluid in its layers leading to a condition called 'acute hydrops'. This causes a sudden loss of vision accompanied by pain, watering and redness. Keratoconus treatment in early stages and advanced stages of this disease vary significantly.

Keratoconus Treatment
HOW DO I KNOW IF I HAVE KERATOCONUS?

Symptoms

Keratoconus usually affects teenagers and young adults

Causes of Keratoconus

Causes Of Keratoconus

Although there is no proven cause for keratoconus, numerous risk factors have been identified which can trigger the progress of the condition.

  • Right ArrowVigorous eye rubbing, especially in childhood [due to allergic causes] is one of the major identified risk factors of Keratoconus.

Some of the other risk factors include family history, age, race and certain genetic conditions such as down syndrome.

HEALTHY EYES FOR CLEAR VISION

Keratoconus Treatment

Keratoconus treatment cannot reverse the thinning of the cornea. However, the basis of keratoconus treatment is to prevent the further progression of the disease so as to reduce the extent of vision loss caused by the disease. Early keratoconus treatment is always advocated to prevent adverse complications. Modern keratoconus treatment modalities are safe and effective with a proven track record.

Riboflavin assisted Corneal Collagen Cross-linking [C3R]

Corneal Cross Linking is a type of cornea surgery and is the most commonly recommended type of keratoconus treatment to strengthen the corneal layers. This treatment involves the use of Riboflavin drops which soak into the cornea. UV radiation is then applied to stimulate the corneal layers to form strong chemical bonds which improve the strength of these layers.

The C3R keratoconus treatment thus prevents the cornea from weakening and bulging further. C3R procedure if done at an early stage can safely help in ensuring that vision loss does not progress. C3R procedure cannot be done at later stages of the disease when the cornea becomes extremely thin or when the integrity of the cornea has been compromised [such as due to scarring or acute hydrops].

In cases of extremely thin corneas, keratoconus treatment using C3R can still be done with some modifications such as hypotonic C3R, contact lens assisted C3R, etc. In case of scarred corneas or compromised corneas, C3R keratoconus treatment would not be effective and the cornea surgery of choice would be to perform a corneal transplant.

All patients require visual rehabilitation after C3R to complete the keratoconus treatment as it DOES NOT REVERSE the corneal astigmatism. Visual rehabilitation is usually in the form of spectacles [in very early stages of the disease] or in the form of specialized contact lenses such as rigid gas permeable lenses[RGP's], Rose-K contact lenses, Scleral or Mini-scleral lenses.

Riboflavin Corneal Collagen Cross Linking Treatment
Keratoplasty Lamellar Penetrating

Keratoplasty: Lamellar(DALK) or Penetrating [Corneal transplantation]

Keratoplasty is a cornea surgery where a donor healthy cornea is grafted in the place of a diseased host cornea. Keratoplasty for a keratoconus eye is only reserved for advanced cases where C3R keratconus treatment is contraindicated or in cases of corneal scarring or corneal compromise. The diseased cornea of the patient is removed out and the donor cornea is grafted in its place. Depending on the extent of the keratoconus and the status of the cornea, corneal transplantation for keratoconus can be:

Penetrating Keratoplasty:
In this keratoconus treatment, all the layers of the cornea layer (full thickness) are replaced with the donor’s cornea. Penetrating keratoplasty cornea surgery is usually recommended when the corneal layers are extensively affected, including its water tightness and transparency.

Lamellar Keratoplasty:
[Partial thickness corneal transplantation cornea surgery] For a keratoconus eye with extreme corneal thinning but whose water-tightness is still present, a partial thickness grafting of only the front layers of the cornea is performed as a method keratoconus treatment. Lamellar keratoplasty has the advantage of having a lower graft rejection and failure rate as compared to the penetrating keratoplasty procedure of keratoconus treatment.

Frequently Asked Questions

What is Keratoconus? Faq Icon

Keratoconus, is a condition where the cornea becomes very steep, thin and irregular and bulge outward like a cone. This condition prevents the irregular cornea from properly focusing the light onto the retina, thereby reducing the vision

What are the symptoms of keratoconus?? Faq Icon

Symptoms of keratoconus include

  • Right ArrowFrequent change of glasses
  • Right ArrowHeadaches
  • Right ArrowVision not correcting completely even with glasses
What is the usual age of onset of keratoconus? How fast does it progress? Faq Icon

It may occur in people from teenages to even 40 years or more. IEven though its diagnosed earlier, it may gradually grow and stabilize.

Does keratoconus affect both eyes? Faq Icon

Yes, it does affect both the eyes in the majority of the cases.

What are the treatment options available? Faq Icon
  • Right ArrowRiboflavin assisted Corneal Collagen Cross-linking [C3R]
  • Right ArrowKeratoplasty: Lamellar [DALK] or Penetrating
Can Keratoconus Go Away On Its Own? Faq Icon

The answer is No. Keratocomus doesn’t fade on its own. The shape of your cornea can't change, without medications, contact lenses or even surgery.

Can Keratoconus Cause Dry Eye? Faq Icon

Yes, there is a high chance because your eyes lose the ability to spread tears over your uneven cornea.

Does Keratoconus Cause Eye Pain? Faq Icon

In some cases your eyes will ache due to the keratoconus. Eye irritation is common accompanied with some mere pain.

What Do I Do If I Think I Have Keratoconus? Faq Icon

Consult your doctor immediately and get your eyes checked. And Based on the consultation and prescription choose your lenses or even surgery in severe cases.

What about relatives of people with keratoconus? Faq Icon

In those cases, one copy of the altered gene in each cell may cause the disorder. Usually, it is not inherited. But there are rare cases which can be seen too.

Can I undergo LASIK correction for keratoconus? Faq Icon

Absolutely not! Keratoconus is the number one contraindication for LASIK procedure as LASIK reshapes the cornea by thinning out the central cornea. Since the cornea is already weak, irregular and thin in keratoconus, further thinning out the cornea would have disastrous effects.