Keratoconus 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.
This corneal disease can lead to distortion of vision with multiple images, streaking and sensitivity to light. This disease appears to run in families. There are tiny fibres 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 becomes progressively more cone shaped.Who Are At Risk?
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 this disorder.
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.
Signs and symptoms 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.
Laboratory studies to be done are as follows:-
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 consist of videokeratography derived indices which when abnormal in value should alert the clinician to consider a diagnosis of keratoconus.
Rigid contact lenses are the mainstay in the treatment of this corneal disease.
Keratoconus can rarely progress to acute corneal hydrops. It can lead to Central stromal oedema and secondary severe corneal scarring.
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, stabilises after some time in most patients.
• Keratitis, interstitial
• Contact lens complications
• Pellucid marginal degeneration
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