A complete guide on keratoconus diagnosis and treatment

A complete guide on keratoconus diagnosis and treatment

The word keratoconus is formed by two Greek words: kerato, meaning cornea, and konus, meaning cone. It is an eye condition in which the clear tissue in front of the eye (cornea), bulges outward, leading to decreased or distorted vision. This eye condition hampers many day-to-day activities like driving, typing, watching television, etc.

What causes keratoconus?

Collagen helps to hold the cornea in its place. Collagen is made up of tiny fibres of proteins. When these fibres become weak, they struggle to hold and the cornea becomes progressively cone-shaped.

Keratoconus is not usually genetic, but sometimes it runs in families. Its onset is usually during puberty and is often related to allergies (hay fever, asthma, and eczema). Chronic eye rubbing can aggravate this eye condition.

Some of the other symptoms of keratoconus include:

  • Reduced vision
  • Frequent changing power of prescribed glasses
  • Excessive eye rubbing
  • Double vision
  • High cylindrical number
  • Finding halos and shadows around objects

The objective of keratoconus treatment is to stop its progression and to provide the patient with the aid to improve the impaired vision.

Keratoconus diagnosis

Your ophthalmologist will review your medical and family history before starting the treatment. The eye specialist may conduct different sets of tests to assess the current status and the shape of the cornea. Those tests include:

  • Eye refraction test: An eye refraction test is also known as a vision test. It is an examination to check an individual's ability to see at a specific distance. During the test, you are asked to read letters or recognize symbols on a chart hanging on a wall. Your optometrist asks you to do this exercise by changing lenses of differing strength through a device.
  • Slit-lamp examination: A slit-lamp examination is also known as biomicroscopy. During this test, your optometrist shines a light through a microscope to check for diseases or injuries in your eyes. It is a crucial tool to determine the health of your eyes.
  • Keratometry: A keratometer is also a known ophthalmometer. It is a diagnostic instrument that measures the corneal curvature and analyzes the power of the cornea.
  • Computerized corneal mapping: Computerized corneal mapping is beneficial in evaluating diseases, abrasions, and injuries of the cornea. It is a non-invasive imaging technique for mapping the surface curvature of the cornea with the help of latest machines like Pentacam.

Keratoconus treatment

The course of keratoconus treatment depends on the severity of the condition. In the case of mild to moderate keratoconus, contact lenses or eyeglasses are enough to provide the patient with perfect vision. But if keratoconus has advanced and is not treatable with lenses or glasses, then surgical intervention may become necessary.

There are other ways to treat keratoconus, like:

  • Collagen cross-linking: Collagen cross-linking aims at strengthening the cornea through the use of UV rays and riboflavin (Vitamin B2, a photosensitizing agent). This treatment stiffens or flatten the cornea and prevents it from bulging.

Why go for C3R?
No stitches
No incisions
Quick recovery
No need to wear lenses every day

The patient can go back home the day after the treatment. But, he/she is advised to take rest for 2-3 days before resuming work.

  • Intacs: Intacs are acrylic rings inserted in the corneal stroma to lessen corneal irregularities and to stabilize it. This treatment can slow the progression of keratoconus and minimize the chances for a corneal transplant.
  • Keratoplasty or Corneal transplant: In case of severe scarring and thinning, a corneal transplant is considered as the last resort to treat keratoconus. This surgery is known as keratoplasty. Based on the extent of the scarring and thickness of the cornea, the surgeon opts for a full-thickness procedure called Penetrating Keratoplasty, or a partial thickness procedure called Lamellar Keratoplasty. In this procedure, the damaged cornea of the patient is replaced with a donor's healthy cornea.

Though keratoplasty is generally a very successful procedure, it involves a few possible complications. The risks include graft rejection, infection, inability to wear contact lenses, low vision, and astigmatism.

Post-surgery care for keratoconus

Discharge instructions

  • Return to your eye hospital/emergency department if you feel any deterioration in your vision.
  • Contact your surgeon again if you develop sudden and sharp eye pain after the surgery.

Follow up care

  • Get in touch with your eye care provider if you have any queries about your condition or care.
  • Wear contact lens or eyeglasses as prescribed by your doctor
  • Prevent yourself from exposure to excessive sunlight. Direct UV rays can cause your condition worse. Wear sunglasses, if going out.

Living with keratoconus
There are some general precautions one can take if he/she wants to decrease the chances of keratoconus progression:

  • Don't rub your eyes
  • Control eye allergies
  • Wear sunglasses in bright sun
  • Optimize your contact lens fit
  • Eat a healthy diet

Post-surgical aftercare is essential. Therefore, it is good to schedule follow-up appointments with your doctor up to six months after keratoconus surgery to monitor your progress.

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