Keratoconus: Causes, Signs, Symptoms, & Treatment

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Mac 6, 2023

It is distressing to perform tasks such as driving your car at night when your vision is distorted, slightly blurred, or cloudy. Even when you’re doing your favorite weekend activity of reading books has become dreadful because you get headaches all the time.

In that case, you might want to get your eyes checked. If you suffer from common farsightedness or shortsightedness, your eyes may not show any physical changes. But if you see your cornea bulging outwards — forming a little bit like a cone — that is one of the keratoconus signs.

How does Keratoconus happen?

Even though keratoconus has been studied for decades, the exact etiology of keratoconus is still unknown. But a common finding states that the loss of collagen in the cornea is the reason behind keratoconus. This is due to the imbalance in the production and destruction of corneal tissue by corneal cells.

The following factors may contribute to getting keratoconus.

  1. Family history.

A parent with keratoconus affects about 1 in 10 people with the condition. It often develops in teenagers and early adults and progresses for 10 to 20 years before stabilizing. But most of the time, it appears out of nowhere. Nevertheless, it is commonly accepted that both genetic and environmental factors are usually contributing to its development.

     2. Underlying disorders.

Keratoconus occasionally occurs when specific underlying diseases are present. These diseases include sleep apnea, asthma, Down syndrome, and a few connective tissue diseases such as brittle cornea syndrome, Marfan syndrome,  and Leber congenital amaurosis.

     3. Environmental risk factors.

Some of the environmental risk factors that might lead to the development of keratoconus are wearing contact lenses and excessive eye rubbing.

Symptoms of keratoconus

It is typical for people with keratoconus to experience zero symptoms in the early stages. But keratoconus signs and symptoms may start to show as the disease gradually gets worse. Its distinct sign is corneal thinning which alters your cornea’s natural dome shape, causing the curvature of your cornea to bulge outward.

You may experience keratoconus symptoms as mentioned below.

  1. Blurred or distorted vision.

The asymmetry in your cornea may cause mild to severe vision distortion and blurriness.

  1. Increased sensitivity to bright light.

Bright light and extreme glare might cause you to experience difficulty seeing during the night. So, driving at night will become a problem because streaks and haloes may appear around bright lights.

  1. Frequent changes in glasses prescription.

In early keratoconus, blurry or distorted vision can be treated with glasses or soft contact lenses. But when the shape of your cornea slowly changes, that’s what leads to prescription changes.

  1. General eye pain.

You might suffer from eye irritation or headaches associated with eye pain and frequent eye rubbing.

Diagnosis & Treatments

Your eye doctor will do a complete eye exam and review your medical and family history during your visit. This includes examining the general condition of your eyes, your visual acuity, your visual field, and your eye movements.

To diagnose keratoconus, your cornea’s curvature will be measured by using a variety of tests such as Pachymetry and slit lamp. But most of the time, an advanced diagnostic machine called a topographer will be used to measure the shape and thickness of your cornea.

This corneal topography test will generate a colored “map” based on the curvature of your cornea. The appearance of these maps varies significantly in keratoconus, which enables the doctor to make an accurate diagnosis.

So what are the keratoconus treatment options? Well, it all depends on the seriousness of your condition.

  1. Early-stage treatment.

In the early stage of the condition, normal eyeglasses or soft contact lenses can be used to correct your vision. But as keratoconus worsens, the number of irregular astigmatisms (the curvature on your cornea) may prevent your vision from being corrected with just glasses. You need a special type of hard contact lens.

  1. Intermediate-stage treatment.

If your keratoconus progresses, corneal collagen cross-linking will be performed to stiffen the cornea. This is a one-time office procedure that involves applying a vitamin B2 solution to the eye, which then will be activated by a calibrated UV light for around 30 minutes.

The thin outer layer of the cornea will need to be removed when performing this procedure to allow the riboflavin (vitamin B2) to penetrate the corneal tissue more easily. The solution induces the formation of new collagen bonds, restoring and preserving some of the cornea’s strength and shape. 

Even though this treatment cannot restore normal vision to the cornea, it can prevent vision from becoming even worse and, in some cases, improve vision. 

  1. Advanced-stage treatment

For some patients, the disease may progress to the point where their vision can no longer be aided with glasses or contact lenses or their cornea becomes dangerously thin. You may opt for two common surgical options.

  • Corneal ring (Intracorneal ring segments)

Since the regular contact lens may become too unpleasant to wear if you have severe keratoconus, corneal ring implantation might become necessary. It is done by inserting two crescent-shaped pieces of plastic called INTACS into your cornea’s central layer which will support and fix certain corneal issues and allow you to see better. The treatment takes around 15 minutes.

  • Corneal transplant (Keratoplasty)

This surgery involves replacing your current cornea — which is too damaged to repair anymore — with a cornea from a donor. Corneal transplants are often performed as outpatient procedures and take around an hour to complete. Post-surgery, your vision will appear blurry for three to six months and medication is compulsory to avoid transplant rejection. In most situations, glasses or contact lenses are required to ensure the best possible eyesight following transplant surgery.

Final Say

Consult an eye doctor at VISTA Eye Specialist if you feel like developing symptoms of keratoconus. Our highly trained doctors will perform a thorough assessment of your eyes to manage your keratoconus effectively with the best treatment plan.

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