Keratoconus is an eye condition characterised by the thinning and bulging of the cornea, the clear, dome-shaped outer surface of the eye that covers the iris and pupil. In a healthy eye, the cornea maintains a smooth, round shape, allowing light to enter the eye and focus properly on the retina. However, in keratoconus, the cornea gradually becomes thinner and weaker, leading to a cone-like protrusion and irregular shape.
COMMON SYMPTOMS
Blurred or Distorted Vision: Vision becomes blurry or distorted, especially at a distance
Astigmatism: Develops, causing distorted or streaky vision
Increased Sensitivity to Light: Experience photophobia, discomfort in bright light
Seeing Halos or Glare: Notice halos or glare around lights, especially at night
Difficulty with Night Vision: Poor contrast sensitivity and depth perception in low light
Eye Irritation or Discomfort: Experience redness, dryness, or irritation, especially with contact lenses
Eye Strain and Fatigue: Experience headaches, eye strain, and difficulty focusing
Difficulty with Contact Lenses: Find contact lenses uncomfortable or difficult to wear due to corneal irregularities
How Is It Diagnosed?
Keratoconus is diagnosed through a comprehensive eye examination conducted by an eye care professional, typically an optometrist or ophthalmologist. The diagnostic process may involve several tests and procedures to evaluate the shape, thickness, and overall health of the cornea. Here are the common steps involved in diagnosing keratoconus:
- Patient History: Gather information on symptoms, family history, and previous eye issues
- Visual Acuity Testing: Assess vision clarity
- Refraction Test: Measure refractive error for glasses or contact lens prescription
- Corneal Topography: Map cornea shape to detect irregularities indicative of keratoconus
- Corneal Pachymetry: Measure corneal thickness; thin corneas may suggest keratoconus
- Slit-Lamp Examination: Examine cornea and eye structures for abnormalities
Treatment Options
There are several treatment options available for keratoconus, ranging from non-surgical approaches to surgical interventions. The choice of treatment depends on the severity of the condition, the progression of keratoconus, and individual factors such as age, corneal thickness, and visual needs. Here are the common non-surgical and surgical treatment options for keratoconus:
NON-SURGICAL
Glasses: In the early stages of keratoconus, mild visual impairment may be corrected with eyeglasses. However, as the condition progresses and the cornea becomes more irregular, glasses may not provide adequate vision correction
Contact Lenses: Rigid Gas Permeable (RGP) and Scleral Lenses are specialised contact lens options for addressing vision issues like keratoconus. RGP lenses offer a smooth optical surface, compensating for corneal irregularities, making them suitable for moderate to advanced keratoconus. On the other hand, Scleral lenses are large and vault over the cornea, resting on the sclera, providing enhanced comfort and stability, which may be preferred for advanced keratoconus or those intolerant to traditional lenses.
Hybrid Contact Lenses: Hybrid lenses combine a rigid center with a soft outer skirt, offering the clarity of RGP lenses with the comfort of soft lenses. Hybrid lenses are suitable for individuals with irregular corneas or high astigmatism.
SURGICAL
Intacs: Intacs are small, semi-circular plastic rings implanted into the cornea to flatten and reshape it. Intacs help improve corneal shape and reduce irregular astigmatism, potentially improving vision in individuals with keratoconus. Intacs are removable and may be an option for individuals who are not candidates for corneal transplant.
Corneal Transplant (Keratoplasty): Corneal transplant procedures, such as Penetrating Keratoplasty (PKP), Deep Anterior Lamellar Keratoplasty (DALK), and Descemet’s Stripping Endothelial Keratoplasty (DSEK) or Descemet’s Membrane Endothelial Keratoplasty (DMEK), replace the damaged cornea with donor tissue. These surgeries are considered for advanced keratoconus or when other treatments are ineffective.
Corneal Collagen Cross-Linking (CXL): Corneal collagen cross-linking is a minimally invasive procedure that involves applying riboflavin (vitamin B2) eye drops to the cornea, followed by exposure to ultraviolet A (UVA) light. This strengthens the corneal collagen fibers, stiffens the cornea, and may help slow down or stabilise the progression of keratoconus.
Contact us today to book an appointment if you are experiencing concerns with your vision. We are here to help address any issues and provide solutions tailored to your individual needs. Our knowledgeable optometrists will conduct a comprehensive evaluation, discuss your treatment options, and develop a tailored plan to address your unique needs and goals.