Diagnosis & Treatment for Keratoconus

Our eyes are very complex structures. One key component is the cornea. This is the clear, domed lens at the very front that protects the pupil and iris. It also serves to refract light as it enters the eye, bending it so that it is focused on the retina, which is the patch of light-sensitive cells found at the back of the eye. Normally, the cornea is a fairly regular dome shape. However, some people find that their cornea starts to bulge outwards in the shape of a cone. This condition is known as keratoconus.

 

What is Keratoconus?

Keratoconus is a condition whereby the cornea becomes progressively thinner and less able to retain an even dome shape. Instead, the weakened fibers of the cornea enable it to bulge outwards into a shape that more closely resembles a cone. It’s not known exactly why some people develop keratoconus, but studies have found that it is more likely in certain situations, including:

• If you have spent a lot of time in the sun without wearing UV protection
  
   

• Excessive exposure to pollution, dry, dusty, and artificially heated/cooled environments
  
   

• Oxidative stress
  
   

• Persistent eye rubbing
  
   

• Trauma to the eye

As the cornea progressively thins, it also projects outwards. This can make wearing contact lenses difficult, if not impossible. The uneven shape of the cornea also affects how light is refracted by your eyes, affecting the quality of your vision.

 

How is Keratoconus Diagnosed?

Keratoconus causes a range of symptoms, and it may be these that you use to decide that you need to make an appointment with your eye doctor. Some of the symptoms of keratoconus include:

• Mildly blurred vision
  
   

• Slightly distorted vision, meaning that lines that should be straight such as lampposts appear wavy instead
  
   

• Redness of the eyes
  
   

• Swelling around the eyes
  
   

• Increased sensitivity to light
  
   

• Finding it hard to drive at night due to glare
  
   

• Finding it hard to wear contact lenses as they may feel uncomfortable and be a poor fit

Fortunately, keratoconus can usually be diagnosed with a fairly simple eye exam. Your eye doctor will use special equipment to examine the shape of your cornea and measure the extent of the curve of the cornea. This might be done using a special imaging technique called topography, in which a 3D scan of the cornea is taken. This enables your eye doctor to see how severely your cornea is affected.

 

How is Keratoconus Treated?

There are a number of different options for treating keratoconus, including scleral lenses. Scleral lenses are specialty contact lenses that are designed especially for people with corneal abnormalities like keratoconus. This is because, unlike regular contacts, scleral lenses are more curved and vault over the surface of the cornea rather than lying flat against it. This creates enough space to accommodate the bulge of the cornea, while still correcting your vision.

Sclera lenses also have a number of other benefits. They are larger in diameter than regular contact lenses, which makes them more stable on the eye and easier to handle. The space between the front surface of your cornea and the back of the lens also acts as a fluid reservoir to keep moisture on the surface of the eyes and ensuring that they remain hydrated.

Scleral lenses may correct your vision while you have keratoconus, but they don’t really treat the underlying problem. Fortunately, there are several treatments which can, including:

Intacs: these are small, curved devices that are surgically implanted into your cornea to flatten the bulge and improve your vision.

Collagen cross-linking: this is when a special UV light is used alongside eye drops to strengthen the fibers of your cornea, slowing the progression of any bulging.

Surgical corneal transplant: this is when your natural cornea is removed and replaced with healthy corneal tissue from a donor.

If you have questions about keratoconus or if you would like to make an appointment to discuss your vision, please contact our expert eye care team at HineSight Vision Care in Flowood, MS  at (601) 519-4466.