Keratoconus

Keratoconus is a condition where the cornea – the clear, dome shaped front surface of your eye – gradually thins and bulges outward into a cone. A healthy cornea is spherical in shape, allowing light entering the eye to come into focus, forming a clear image. A cone shaped cornea however, causes blurred vision and may also cause sensitivity to light and glare. Keratoconus usually affects both eyes, although it often affects one eye more than the other.

Keratoconus usually begins to affect people in their teenage years or early twenties. The condition will often progress at varying rates before stabilising in your 30s or 40s.

What causes keratoconus

The exact cause of Keratoconus remains unknown, although it is believed that the predisposition to develop the disease is present at birth. Factors that may increase the risk of developing Keratoconus include:

• Vigorous eye rubbing
• Having a family history of Keratoconus – Around 1 in 10 people with Keratoconus also have a parent with the condition
• Having a family history of Keratoconus – Around 1 in 10 people with Keratoconus also have a parent with the condition

Symptoms

Symptoms of Keratoconus may include a combination of the following and may change as the disease progresses:

• Blurred or Distorted vision
• Double vision or Ghosting of images
• Increased sensitivity to bright lights
• Glare and Halos around lights
• Difficulty seeing at night
• Frequent changes in glasses prescription
• Sudden blurring or Clouding of vision

Treatment

In the early stages of Keratoconus, vision problems can often be corrected with glasses or soft contact lenses. As the condition progresses and the cornea becomes more irregular, you may have to be fitted with hard contact lenses such as rigid gas permeable contact lenses or scleral lenses. If the Keratoconus progresses to an advanced stage, a corneal transplant may be needed to restore sight.

Corneal collagen cross-linking is the only treatment that helps to slow or stop Keratoconus from progressing. Stabilising the Keratoconus aims to stop worsening of the disease and preserve your vision.

Corneal cross-linking

During corneal cross-linking, the cornea is saturated with riboflavin (Vitamin B2) drops and then treated with ultraviolet A light. This causes collagen cross-linking of the cornea, which stiffens the cornea to prevent further shape changes.

Corneal collagen cross-linking helps to reduce the risk of progressive vision loss by stabilising the cornea. The treatment in itself does not reverse Keratoconus or improve vision. In some patients, corneal cross-linking may be combined with a reshaping procedure to help regularise and improve the overall shape of the cornea. Speak to your corneal specialist to find out if you are eligible for this procedure.

Corneal transplant

You may need a corneal transplant if you have corneal scarring, extreme thinning of your cornea, poor vision with contact lenses or an inability to wear contact lenses. Cornea transplant surgery for Keratoconus is generally very successful, but often glasses and/or hard contact lenses are still required after surgery.