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Caring for your Keratoconus

Keratoconus is the degeneration of the structure of the cornea or the front part of the eye. It is a vision problem where the cornea which is normally round becomes thin, irregular and cone-shaped. When this happens, the light entering the eye does not focus correctly on the retina which causes distortion of vision. It is believed to be a defect in collagen or the tissue that makes up most of the cornea.

 

Symptoms

Here are some symptoms that may indicate that you are suffering from keratoconus:

•    Early stages of this condition may be accompanied by distortion and slight blurring of vision with increased sensitivity to light and glare. The condition usually starts with near-sightedness. These symptoms may appear when a patient is in the late teens or late 20s and the progression may be slow.

•    As the keratoconus progresses, there is increased bulging of the cornea and distortion of vision.

•    Tiny cracks may develop due to the strain of the protruding cone-like shape of the cornea. When this happens, the cornea may swell for weeks or months. When the crack heals, it is gradually replaced by scar tissue. This may be temporarily relieved by eye drops prescribed by your doctor.

Tests

Keratoconus may be discovered with the following tests:

•    Slit lamp examination of the cornea

•    Corneal topography where a map of the curve of the cornea is created.

•    Pachymetry is a painless test that may be done when the condition is advanced and the cornea is thinner at the point of the cone.

Treatment

When suffering from keratoconus, the following treatments may be undertaken:

•    Eyeglasses or soft contact lenses to correct astigmatism and mild near-sightedness caused by this condition.

•    Rigid gas-permeable contact lenses to correct vision when the disorder progresses and the cornea becomes thinner and changes shape. The lenses should be fitted carefully and checked regularly since they may need to be changed to attain good vision.

•    Glasses and especially contact lenses are the basis of keratoconus management.  Surgical intervention although it plays a very important role very rarely will eliminate the need for an optical appliance.

•    High frequency radio energy or corneal implants called intra-corneal ring segments may be used to change the shape of the cornea to improve the vision with contact lenses.

•    Corneal transplant may be needed in some cases of keratoconus. The recovery period will not be long but glasses or contact lenses may still need to be worn to correct vision. While there is a risk of rejection in this transplantation, the risk is much lower compared to other organ transplants.

•    Corneal cross-linking is an established treatment that will harden the cornea and stop the condition from getting worse.

•    Afterwards, laser vision correction may be done to reshape the cornea. Laser eye surgery for keratoconus is to be avoided at all cost.  Studies presently are trying to work out whether it might have a role to play after cross-linking has been performed.

Studies show that this eye condition cannot be prevented. Thus, it is essential that when you begin to observe its symptoms, you should immediately see your eye doctor so that appropriate tests can be conducted. That way, early treatments may be undertaken in order to prevent the keratoconus from progressing.

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

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