5 Common Keratoconus Questions

1. What Is Keratoconus?

Keratoconus is a progressive, non-inflammatory disease which affects the cornea. The cornea is the window of the eye and the main area where images are focused when we see. Keratoconus causes thinning of the cornea which leads to bulging, creating a cone-like shape of the cornea. This makes the vision distorted and blurred overtime which gets worse. Most patients with keratoconus are usually very near-sighted with a high level of astigmatism which cannot be corrected with glasses.

2. What Are the Symptoms of Keratoconus?

Early signs of keratoconus can be constant changes in prescription leading to having to change glasses more often. Driving at night also tends to become more difficult as the disease progresses. Many patients often experience glare and halos, double vision, and ghosting amongst other visual disturbances.

3. What Causes Keratoconus?

In a normal eye, small protein fibres called collagen help to keep the cornea in a dome-like shape and free from bulges. In an eye that suffers from keratoconus, the collagen fibres become weak and cannot keep the shape of the eye, which causes the progressive bulging of the cornea. Keratoconus can run in families and can develop from a young age. If it does run in the family, it is recommended having children’s eyes checked with an ophthalmologist for signs of keratoconus regularly. Keratoconus can also develop at a later age from certain things like chronic eye rubbing.

4. What Can Be Done for Keratoconus?

Depending on the severity of the keratoconus will depend on what treatment option would be recommended. Initially glasses or soft contact lenses may be advised to help with the changing vision. As the disease progresses specialist contact lenses may be required such as hard contact lenses to try and more adequately correct the vision, but these have to be correctly fitted and regular follow ups are needed to monitor the vision. Prior to the year 2000 in the UK, there was nothing that could be done to slow or stop disease progression, however a now common procedure is corneal collagen cross linking. This involves using riboflavin (vitamin B2) and ultraviolet light to help strengthen the collagen fibres and create more cross linking between them to increase the strength and rigidity of the cornea. Corneal collagen cross linking is the procedure of choice for most ophthalmologists and highly recommended due to its safety and effectiveness that is proven by many major studies. Other treatments that may be suggested are corneal ring implants and laser photo therapeutic keratoplasty (PTK). If the disease has progressed too far the only option to help may be to have a corneal transplant, this would only be recommended in severe cases where no other treatments can help.

5. Is There a Cure for Keratoconus?

At the moment, there is no cure for keratoconus. As mentioned above the only treatment to stop or slow the disease progression is corneal collagen cross linking. It is extremely important for keratoconus patients to have regular follow up appointments and to follow the advice of their ophthalmologist. If keratoconus is left without regular monitoring or treatment it can progress to a severe case where a corneal transplant is the only option and there are no guarantees this, or any other treatment, will work or help.