What is Keratoconus?
Keratoconus is a progressive eye condition where the normally round, dome-shaped cornea thins and begins to bulge into a cone-like shape. This change in the cornea's shape prevents light from focusing correctly on the retina, causing distorted and blurry vision. While the condition can affect both eyes, it often progresses at a different rate in each.
Symptoms of Keratoconus
Keratoconus typically begins in a person's late teens or early 20s and can progress over a decade or longer. In its early stages, symptoms may be mild and can be corrected with glasses. As the condition advances, symptoms can become more severe and may include:
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Blurred or distorted vision that worsens over time.
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Increased light sensitivity (photophobia).
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Halos or glare around lights.
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Frequent changes in glasses prescription.
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A sudden worsening or clouding of vision in one eye.
Causes of Keratoconus
The exact cause of keratoconus is not fully understood, but it is believed to be a combination of genetic and environmental factors.
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Risk factors
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Genetics: Approximately 1 in 10 people with keratoconus has a parent who has the condition.
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Eye Rubbing: Chronic, vigorous eye rubbing is a significant risk factor that can damage the cornea's delicate collagen fibers and accelerate the progression of keratoconus.
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Allergies & Asthma: These conditions are often associated with keratoconus, likely due to the inflammation and irritation that leads to eye rubbing.
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Diagnosis of Keratoconus
Early diagnosis is crucial for managing keratoconus and slowing its progression. An ophthalmologist can diagnose the condition during a comprehensive eye examination. The diagnosis typically involves:
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Corneal Topography: This is the most important diagnostic tool. A corneal topographer creates a detailed, three-dimensional map of the cornea's surface, revealing any steepening or irregularity characteristic of keratoconus.
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Slit-Lamp Examination: The doctor will use a special microscope to examine the cornea and look for thinning or other subtle signs of the condition.
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Refraction: A test to check for astigmatism and to determine a prescription for glasses or contact lenses.
Treatment of Keratoconus
The goal of treatment is to stabilize the cornea, improve vision, and prevent further progression.
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Mild Keratoconus (Early Stage)
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In the early stages, vision can often be corrected with glasses or special contact lenses, such as hard contact lenses, which provide a smooth, regular surface for light to pass through.
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Moderate to Advanced Keratoconus
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For more advanced cases, or when the condition is progressing, the following treatments are often recommended:
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Corneal Cross-Linking (CXL): A minimally invasive procedure that strengthens the cornea's collagen fibers. CXL involves applying a vitamin B2 solution (riboflavin) to the cornea and activating it with UV light. This process creates new connections between the collagen fibers, making the cornea stronger and more resistant to bulging. CXL is the only proven treatment to slow or halt the progression of keratoconus.
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Corneal Transplantation: For advanced keratoconus where vision cannot be corrected with contact lenses or where the cornea has become scarred, a corneal transplant may be necessary. The damaged cornea is replaced with healthy donor tissue to restore vision.
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