Keratoconus

  • Keratoconus affects 1 out of every 2,000 people.
  • Keratoconus can affect anyone at any age (usually diagnosed in late teens or early 20’s).
  • There are no race, cultural, or environmental conditions that have been proven to cause Keratoconus.

The cornea is the outer front cover that refracts light into your eye. The cornea is usually dome-shaped as it follows the shape of your eye. During keratoconus, the cornea thins out and begins to shape into a cone instead of a dome.

Symptoms

When the keratoconus develops, the person suffering from this condition will experience the following symptoms:

  1. Eye Strain, Headaches and General Eye Pain
  2. Eye Irritation
  3. Increased Sensitivity to Light
  4. Halos and “Ghosting” of Images
  5. Difficulty driving at night

All of these symptoms can also be indicative of other eye conditions or serious eye diseases. If you or a loved one is experiencing any of these conditions, it is important to seek a consultation with Dr. Donelson. Only a doctor trained in diagnosing keratoconous, such as Dr. Donelson, can determine if you have the condition or if any of your symptoms may be the result of a different issue.

Treatments

The treatments for keratoconus vary, depending upon the degree of the condition.

Glasses or Soft Contact Lenses

Initially when someone has keratoconus, glasses or soft contact lenses can be used to help deal with the negative effects on their eyesight. Keratoconus can cause astigmatism or nearsightedness and glasses or contacts can assist with these distortions to one’s vision.

Rigid Gas Permeable Contacts

Eventually keratoconus will progress beyond the point where traditional glasses and/or contacts can be of assistance. When this happens, Dr. Donelson will prescribe rigid, gas permeable contacts. These contacts will provide a hard surface in which the cornea’s irregular shape is smoothed back into a dome shape again.

The key to gas permeable contacts is having a precise fit. The user must be measured accurately in order to provide the perfect fit for your unique eyes. These contact lenses are more uncomfortable than soft contacts and are more expensive to replace.

Intacs

Intacs (intrastromal corneal ring segments) are clear, precision-engineered, polymer crescents that are placed into the channeled layers of the cornea. They provide a new option to improve both corrected and uncorrected vision, and may defer the need for a corneal transplant.

The goal of the Intacs procedure is to provide the keratoconic patient with the ability to achieve improved functional vision with contact lenses or glasses, and, in some cases, without them. In the few patients that later required a cornea transplant after having the Intacs procedure, their transplants were completed without complication following removal of Intacs.

Intacs may provide an effective option prior to considering a cornea transplant. Intacs were originally designed and FDA approved to correct mild nearsightedness, and now Intacs have emerged as a new therapy for treating patients with keratoconus.

Collagen Crosslinking

Although it isn’t a cure for keratoconus, Corneal Collagen Crosslinking (CXL) is a new procedure that can slow or arrest the progression of the condition.

Collagen Crosslinks are chemical bonds within the cornea that provide for a strong cornea and prevent the cornea from bulging out or becoming irregular in shape. In a weak cornea there are less collagen crosslinks than in a normal cornea.

During this treatment, the outer layer of the eye, or the epithelium, is removed. Then riboflavin drops are put into the eye to saturate it. Once this step is complete, a UV light is applied to the eye. The UV light reacts with the riboflavin to create additional collagen crosslinks, thus strengthening the cornea.

Once CXL has been performed, the use of glasses and/or contact lenses will still be needed to account for the distortion of vision that has already occurred as a result of keratoconus.

Corneal Transplant

In about 15-20% of keratoconus cases, it becomes necessary for the patient to receive a full corneal transplant. This decision comes after the patient becomes intolerant of contact lenses or sight can no longer be corrected by contacts.

This procedure is an out-patient procedure where the diseased cornea is removed and replaced by the donor cornea. A tool called a trephine is used to cut the small “button” of tissue from both the patient and the donor, to ensure the size is exactly the same. The surgeon then sutures the tissue into place.

After the procedure, you will be required to wear a patch until the outer layer of the cornea, or the epithelium, heals. Our doctors will determine when the patch is no longer needed. Protection must be used so as to prevent any trauma to the eye. The sutures are very small and fine, and because there is no blood flow to the cornea, your eye will be slow to heal. Glasses are required during the day and a protective covering should be used at night.

We have found that our keratoconus patients tend to have a lot of questions about their condition, as well as possible treatments. Give us a call to set up an appointment. We’ll be more than happy to discuss any questions and concerns you may have, as well as recommend the best course of action for treating your condition.