Keratoconus/Corneal Ectasia
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Introduction
In keratoconus, the cornea becomes thin and gradually bulges outward into a cone shape. This irregular shape can cause vision problems, including blurred vision, sensitivity to light, and difficulty seeing at night.
Symptoms of Keratoconus:
- Blurred or distorted vision
- Increased sensitivity to light (photophobia)
- Difficulty seeing at night (night vision problems)
- Frequent changes in eyeglass or contact lens prescription
- Double vision or ghosting of images
- Eye strain or discomfort
Diagnosis
Keratoconus is typically diagnosed through a comprehensive eye examination, which may include tests such as corneal topography / tomography and corneal pachymetry to assess the shape and thickness of the cornea. A cornea surgeon is well equipped to diagnose, assess progression of the keratoconus and determine treatment.
TOPO KCONUS
Treatment options for keratoconus depend on the severity of the condition and may include:
Glasses
- Glasses can provide initial correction for mild keratoconus.
- However, as keratoconus progresses, glasses may become less effective in providing satisfactory vision correction.
Contact Lenses
Soft Contact Lenses, Rigid Gas Permeable (RGP) Contact Lenses , Rose- K lenses or Scleral Contact Lenses are beneficial for patients depending on the severity of the disease.
Corneal Cross-Linking (CXL)
- Considered a standard treatment for progressive keratoconus.
- CXL involves applying riboflavin drops to the cornea, followed by exposure to ultraviolet light. This strengthens the corneal collagen fibers, halting or slowing the progression of the disease.
Intra-corneal Ring Segments (ICRS)
ICRS, such as INTACS, are small, arc-shaped plastic implants inserted into the cornea assisted by femtosecond laser, to reshape and flatten it, improving visual acuity.
Corneal Allogenic Intra Stromal Ring Segments (CAIRS)
Newer techniques have evolved which use donor corneal tissue instead of plastic implants to reshape the cornea. This is more biocompatible, and reduces the risk of complications associated with plastic implants.
Corneal Transplantation
- Reserved for patients with advanced keratoconus who do not respond to other treatments.
- Techniques include Deep Anterior Lamellar Keratoplasty (DALK) ie partial corneal transplantation, wherein the inner layer of cornea is preserved thereby reducing the risk of rejection, or Penetrating Keratoplasty (PKP) ie full thickness corneal transplantation which replaces all the layers of cornea, usually performed if there is a corneal scar in the central cornea.