This eye disease causes the cornea to grow thinner and bulge forward in an irregular cone-shape.
Treatment options range from gas permeable contact lenses to a cornea transplant.
What is Keratoconus?
To understand this eye care issue, let’s begin with a basic description of corneal structure.
A number of tiny collagen fibers hold your cornea in place. In a healthy eye, protective antioxidants work to destroy damaging by-products manufactured naturally by corneal cells. Yet sometimes there is a reduction in the amount of these protective antioxidants. When that happens, it weakens the collagen fibers to the point that they are too delicate to hold the cornea in a round shape. Consequently, your cornea will bulge outward to resemble a cone. Without a cornea in the proper dome shape, your vision is affected and generally becomes blurry or distorted. To see clearly, keratoconus must be treated by an eye doctor.
Our eye care specialists in Washington, DC, are experienced and knowledgeable about keratoconus, and we prepared this guide to help keep our patients informed.
Am I at risk for keratoconus?
First of all, be aware that this eye condition is relatively rare, with approximately one person out of every 2,000 having keratoconus. Generally, it begins during the teenage years and can then progress quickly or slowly. Every case is different.
Do you have a relative with keratoconus? If your answer is Yes, be advised that it tends to run in families. Therefore we urge you and your children strongly to visit for regular comprehensive eye exams in our eye care center in Washington, DC!
Have you ever suffered a serious eye injury? If so, you may have been told that specific types of eye injuries may also increase your risk of keratoconus.
In addition, diseases such as vernal keratoconjunctivitis, retinitis pigmentosa, and retinopathy of prematurity are all associated with this corneal abnormality. Some examples of systemic conditions that raise the incidence of keratoconus are Down syndrome and Ehlers-Danlos syndrome.
How do I know if I have keratoconus? What are the symptoms?
When keratoconus makes the cornea bulge outward, it affects vision in two different ways. First, the normally smooth surface of your cornea becomes wavy, which is called irregular astigmatism. Second, corneal expansion leads to nearsightedness and it becomes impossible to focus without eyeglasses or contact lenses. Generally, problems start in one eye and make their way to the other eye too.
As a result of these changes in the corneal surface, people with keratoconus usually experience the following symptoms:
- Sudden change of vision in only one eye
- Blurred vision
- Double vision from just one eye
- Objects appear distorted, both near and distant
- Halos around bright lights at night; glare
- Streaking of lights
- Triple ghost images
How is keratoconus diagnosed?
Symptoms are not enough to make a solid diagnosis of keratoconus. Our Washington, DC, eye doctors will inspect your cornea thoroughly during a comprehensive eye exam. A diagnosis of keratoconus is based on corneal measurements, which we take using computerized Corneal Topography – in which digital technology snaps a picture of your cornea and analyzes it immediately.
What are my options for keratoconus treatment in Washington, DC?
The first treatment typically recommended for keratoconus is new prescription eyeglasses. However, when this doesn’t work well enough, specialty contact lenses are the next line of action.
Specialty Contact Lenses
Standard contact lenses do not usually sit comfortably on corneas affected by keratoconus, which is why specialty contacts are a recommended solution for vision correction.
- Scleral lenses: These specialized rigid, gas permeable contact lenses are a popular treatment for keratoconus. Scleral lenses span the entire cornea with a nicely rounded surface, thereby replacing the irregular cone-shaped cornea. They have an extra-wide diameter that vaults over the cornea to rest only on the whites of your eyes (sclera). By not making contact with the corneal surface, they enable ultimate comfort with clear vision.
- Hybrid contact lenses: These specialty contacts truly combine the best of both worlds. They have a hard oxygen-permeable middle zone that is encircled by a soft rim. Patients thereby enjoy the sharp vision of a gas permeable lens along with the comfort of soft lenses.
- Piggybacking lenses: Sometimes the best keratoconus treatment involves wearing two contact lenses. A soft lens is placed directly on the eye, with a hard lens resting on top of it. The soft lens provides a cushion that enhances comfort for many people.
Phototherapeutic keratectomy (PTK)
Overstretched collagen fibers that characterize severe keratoconus may cause extreme scarring. When the cornea tears as a consequence of this scarring, it may lead to inflammation. Once the swelling goes down, a very large scar often remains and wearing contact lenses can be uncomfortable due to this scar. If this happens, there is a specialized laser procedure called PTK that removes tissue from the cornea to smooth out the corneal surface.
Small plastic inserts are surgically placed in the edges of the cornea, under the eye’s surface. Intacs can help mold the cornea to give crisper vision. This keratoconus treatment may be advised for patients who have lost functional eyesight, and they often delay the need for a corneal transplant.
This is generally performed as a last resort treatment for keratoconus. During this surgical procedure, the center of the cornea is removed and replaced with a donor cornea. Your eye surgeon will stitch the new cornea into place. Afterwards, you’ll need to wear contact lenses to achieve adequate vision.
Only a comprehensive eye exam can confirm or rule out the presence of keratoconus. If you experience any of the symptoms or you have a family history of this ocular condition, contact us to schedule an appointment with our expert Washington, DC, eye care specialists!