Although patients may be aware of corneal diseases, they may not be fully aware of Keratoconus, and everything connected to this cornea condition. At Pacific Eye Institute, our cornea specialists are committed to making sure patients are educated on corneal conditions like keratoconus. We want our patients to be well-versed in the risk factors, causes, symptoms, treatment options, and relevant aspects of keratoconus. Keep reading to learn more.

What is Keratoconus?

Keratoconus is usually associated with a thinning disorder found in the cornea (the outer covering of the eye). This condition causes the cornea, which is typically round and symmetrical shaped, to be distorted to a cone-like bulge. This then results in significant vision problems. For patients experiencing keratoconus, objects may appear as if they are looking through a distorted or warped glass.  

Keratoconus generally progresses slowly, and it sometimes stops its progression as the patient gets older. However, a keratoconus patient will only get better with treatment.

What are the signs and symptoms of Keratoconus?

The first symptom of keratoconus is distorted and blurred vision. However, this can be corrected with classes in the early stages. Eventually, contacts would be needed as vision may not be completely corrected by wearing eyeglasses. Cornea swelling and scarring may also occur as the symptoms develop. Glare, halos around lights, increased sensitivity to light, and trouble seeing at night are also possible symptoms.

Dr. Christopher Blanton, one of our cornea specialists at Pacific Eye Institute, advises patients with astigmatism whose prescription appears to progressively get worse to be aware of keratoconus and strongly recommends they see their eye care provider to determine if they do, in fact, have keratoconus.

Who does keratoconus affect?

What are the risk factors connected to this corneal disorder? Keratoconus is not as rare as you would imagine as it affects 1 out of 2,000 people. Up to 1 in 500 may have asymptomatic keratoconus. Although this disease usually shows up in younger people and teenagers, it can also be diagnosed in older individuals. Keratoconus is hereditary and often runs in families. Allergies and sleep apnea are also risk factors associated with keratoconus. Individuals with allergies often rub their eyes. Sleep apnea patients try to avoid snoring by sleeping on their side or stomach thereby putting pressure on their eyes and contributing to keratoconus progression.

What are keratoconus treatment options?

The treatment options for keratoconus are aimed at two major goals. One goal is to stop the progression of the irregular cornea curvature, and this is achieved with corneal crosslinking. The other goal is to improve vision quality by neutralizing the astigmatism caused by the asymmetric curvature. This can be accomplished with corneal transplants, specialty contact lenses, or corneal inlay.

“Today we have many different types of treatment options for different levels of Keratoconus. It is critical that each patient discuss their options with their doctor to find which treatment is best for them specifically. Be sure to ask your eye doctor if you might benefit from any of these new advances in care,” Dr. Blanton said.

At Pacific Eye Institute, we offer corneal crosslinking, provide RGP lenses, scleral, corneal inlays, and corneal transplants.

Crosslinking (Treatment to Halt Keratoconus Progression)

Corneal collagen crosslinking (CXL) is a minimally invasive technique that uses ultraviolet (UV) light and a photosensitizer called riboflavin (vitamin B2) to strengthen the cornea and reduce the progression of keratoconus. In the cornea, collagen crosslinking occurs naturally with aging, which may be one reason why keratoconus progression is believed to slow with age. This bonding process appears to be sped up through the application of ultraviolet light and riboflavin to the cornea.

During the crosslinking procedure, patients are given numbing drops, and a lid separator is placed to hold their eyelids open. Riboflavin drops are used to moisten the front of the eye and deliver the riboflavin into the cornea. This usually takes 10 to 30 minutes. After the riboflavin is present throughout the cornea, the UV light is positioned in front of the eye and delivered to the cornea. This usually takes about 30 minutes. Various drops and a contact lens may be used to aid in the healing, and the patient is seen over the next few months to monitor the healing response.

It is typically 4-6 weeks before a contact lens can be worn again after the treatment. Most patients diagnosed with keratoconus, regardless of severity, qualify for corneal crosslinking.

Other Treatment Options (Treatments to Improve Quality of Vision)

While crosslinking is the primary treatment option to halt the progression of keratoconus, there are other treatments aimed at improving vision quality. Of course, we would coordinate with your primary eye doctor if any of these plans are right for you. The treatment plans are listed below.

Gas Permeable Contact Lenses

These are hard contact lenses that retain their shape and position on the eye better than soft contact lenses. Also known as rigid gas permeable (RGP) lenses.  

Scleral Lenses

Scleral lenses are hard contact lenses that leave space between the lens and the natural cornea. This allows tears to be trapped below the lens and provides a more regular shape of light rays on the outside of the contact lens.

Corneal Inlays

Intacs, or corneal inlays, are thin, clear, semi-circular plastic ring inserts that provide a unique alternative to contact lenses and can sometimes postpone the need for a corneal transplant. The procedure allows the cornea to be reshaped without removing any tissue.

Intacs are designed to be permanent, but they can be exchanged or even removed if vision needs to change over time. Intacs cannot be felt, are no more visible than a contact lens, and require no maintenance.

Corneal Transplants

Corneal transplants involve using a donor corneal tissue to replace a warped, distorted cornea.

What is the next step after keratoconus treatment?

Visual results after keratoconus differ from patient to patient. Since just one eye is operated on each time, the second eye isn’t affected, and most patients can resume work a few days after.

Glasses or contact lens prescriptions change for a few months after the procedure, and the other eye is typically done when the first eye has glasses or contacts that can work for the patient.

Just like other corneal procedures, we advise patients to avoid pools, saunas, and hot tubs for about two weeks to avoid contaminated water from entering their eyes. Patients experiencing keratoconus are strongly reminded to control their allergies, avoid rubbing their eyes, and avoid sleeping on their faces to slow down the progression of the disease.

If you’re experiencing discomfort in your eyes or any symptoms of keratoconus, call Pacific Eye Institute at (800) 345-8979 to schedule an eye exam with one of our cornea specialists.