Often abbreviated as “KC”, keratoconus is a non-inflammatory eye condition in which the normally round dome-shaped cornea progressively thins, causing a cone-like bulge to develop and resulting in significant visual impairment.
The cornea is the clear window of the eye and is responsible for refracting most of the light coming into the eye. In its earliest stages, keratoconus causes slight blurring and distortion of vision and increased sensitivity to glare and light. These symptoms usually first appear in the late teens and early 20’s.
New research suggests the weakening of the corneal tissue that leads to keratoconus may be due to an imbalance of enzymes within the cornea. Keratoconus may also be associated with overexposure to ultraviolet rays from the sun, excessive eye rubbing, a history of poorly fitted contact lenses or chronic eye irritation.
If not treated early and quickly, it can cause tremendous loss of vision. Usually it may progress for 10 or 20 years and then slow or stabilize. Of course, each eye may be effected differently.
Depending on the severity, eyeglasses or soft contact lenses may be used to correct the mild nearsightedness and astigmatism caused in the early stages of keratoconus.
As the disorder advances and the cornea continues to thin and change shape, rigid gas permeable contact lenses may be prescribed to correct vision more adequately. There are also other options, such as “piggybacking” contact lenses, the use of hybrid contact lenses or scleral and semi-scleral lenses.
In some cases, because keratoconic eyes may become challenging to fit, some patients with a severe form of the disease may require an advanced scleral lens design that doubles as a prosthetic shell. In these cases, surgically applied corneal inserts – intacs – may also be applied. Only in the most severe cases may a corneal transplant be needed as a result of scarring, extreme thinning or contact lens intolerance.
William C. Womble, OD
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