Keratoconus

 

keratoconus 1Keratoconus is a progressive, non inflammatory, corneal disease which occurs when clear, dome-shaped cornea of the eye thins and gradually bulges outward into a cone shape.

Keratoconus can leads to distortion of vision with multiple images, streaking and sensitivity to light. Keratoconus appears to run in families.There are tiny fibers of protein present in the eye called collagen which help to hold the cornea in place and keep it from bulging out. When these fibres become weak, they cannot hold the shape and the cornea become progressively more cone shaped.

Age/sex prevalence of Keratoconus

Keratoconus usually starts at teenage years. It can begin in children or in people of age 30.
Males and females both are equally affected by keratoconus disorder.

Races affected by Keratoconus

Individuals of any race can suffer from keratoconus.

Causes of Keratoconus

Although not definitively identified, genetic inheritance, systemic and ocular associations, eye rubbing, atopy and specifically ocular allergies, and contact lens wearing are proposed risk factors.

Keratoconus sign and symptoms

Signs and symptoms of keratoconus may change with the progress of disease

• Blurred or distorted vision
• Increased sensitivity to bright light and glare
• Problems with vision at night
• Many changes in eyeglass prescriptions
• Sudden worsening or clouding of vision caused by a condition in which the back of your cornea ruptures and fills with fluid.

Investigations of Keratoconus

Laboratory studies to be done are as follows:-

Keratometry
Videokeratography
Slit lamp biomicroscopy
Rigid gas permeable contact lens application allows the clinician to observe evidence of keratoconus.

Imaging studies to be done are as follows:-

• Computer-assisted videokeratography
• Diagnostic use of rigid contact lenses
• Rabinowitz diagnostic criteria consists of videokeratography derived indices which when abnormal in value should alert the clinician to consider a diagnosis of keratoconus.

Treatment of Keratoconus

Rigid contact lenses are the mainstay of keratoconus treatment.

Complications of Keratoconus

Keratoconus can rarely progress to acute corneal hydrops. Keratoconus can leads to Central stromal edema and secondary severe corneal scarring.

Prognosis of Keratoconus

Most patients with keratoconus do well with rigid contact lens care. About 10-20% of patients eventually require corneal transplantation, but this number is believed to increase if good contact lens care is unavailable. Data suggest that this disease, although progressive, stabilizes after some time in most patients.

Differential diagnosis of Keratoconus

• Diplopia
• Keratitis, interstitial
• Contact lens complications
• Pellucid marginal degeneration