KERATOCONUS

 what is keratoconus?

Keratoconus is a vision disorder that occurs when the normally round cornea (the front part of the eye) becomes thin and Irregular(cone) shape. The abnormal shape prevents the light entering the eye from being focused correctly on the retina and causes distortion of vision.

What Causes Keratoconus?

Doctors do not know for sure why people have keratoconus. In some cases, it appears to be genetic (passed down in families). About 1 out of 10 people with keratoconus have a parent who has it too. Keratoconus is also associated with:

• Eye Allergies
• Excessive eye rubbing, and
• Connective tissue disorders like Marfan Syndrome and Ehlers-Danlos syndrome

Symptoms

Keratoconus often starts when people are in their late teens to early 20s. The vision symptoms slowly get worse over a period of about 10 to 20 years.

Keratoconus often affects both eyes, and can lead to very different vision between the two eyes. Symptoms can differ in each eye, and they can change over time.

In the early stage, keratoconus symptoms can include:

• Mild bluring of vision
• Slightly distorted vision where straight lines look bent or wavy
• Increased Sensitivity to light and glare
• eye redness or swelling
  
                                                     Left: normal cornea; right: cornea with keratoconus.

In later stages, keratoconus symptoms often include:

• more blurry and distorted vision
• increased nearsightedness or astigmatism (when your eye cannot focus as well as it should). As a result, you may need new eyeglass prescriptions often.
• not being able to wear contact lens. They may no longer fit properly and they are uncomfortable.

Keratoconus usually takes years to go from early- to late-stage. For some people, though, keratoconus can get worse quickly. The cornea can swell suddenly and start to scar. When the cornea has scar tissue, it loses its smoothness and becomes less clear. As a result, vision grows even more distorted and blurry.

Diagnosis

Keratoconus can be diagnosed through a routine eye exam. Your ophthalmologist will examine your cornea, and may measure its curvature. This helps show if there is a change in its shape. Your ophthalmologist may also map your cornea’s surface using a special computer. This detailed image

shows the condition of the cornea’s surface (Corneal Topography).

How Is Keratoconus Treated?

Keratoconus treatment depends on your symptoms. When your symptoms are mild, your vision can be corrected with eyeglasses. Later you may need to wear special hard contact lenses (Scleral lens Especially) to help keep vision in proper focus.

Here are other ways that your ophthalmologist might treat keratoconus:

• Intacs This is a small curved device that your ophthalmologist surgically puts in your cornea. Intacs help flatten the curvature of your cornea to improve vision.

• Collagen cross-linking(C3R) Cross-linking is surgery to treat a weakened or warped cornea. Disease or sometimes surgery can harm collagen, an important substance that holds the cornea together. “Cross-linking” new collagen fibers together strengthens and reinforces the cornea.

Who Might Benefit from Cross-Linking?

Cross-linking is approved for use in people with:

Keratoconus With keratoconus, the cornea thins and changes shape over time. The cornea—normally round—bulges outward until it’s shaped more like a cone. This causes blurry vision and other symptoms. For some people, glasses or contacts can treat their keratoconus. Others need special contact lenses or surgery.

• Corneal bulging (ectasia) after LASIK surgery.  LASIK removes corneal tissues to correct blurry vision. Rarely, the removal of tissue weakens the cornea. Then it bulges forward, much like keratoconus.

What to Expect with Corneal Cross-Linking

Cross-linking is an outpatient procedure, which means you go home the same day of the surgery. Here’s what to expect:

• While lying down, you will be given drops to numb your eyes.
• Your ophthalmologist first removes the thin, outer layer of the cornea(epithelium). This allows the medication to reach deeper into the cornea. You should not feel any pain due to the numbing drops.

• Vitamin B (riboflavin) eye drop medicine is applied to the cornea for about 30 minutes.
• Next, a special device shines a focused beam of UV light rays at your cornea for close to 30 minutes. The light activates the riboflavin in the cornea. This helps form new bonds between the collagen fibers in your cornea.
• A bandage contact lens is placed over the eye(s). This helps the cornea heal. The bandage lens is left in place for about a week.
• Your ophthalmologist may give you antibiotic and steroid drops to help your eye heal.

After Corneal Cross-Linking

During the first week while your eye is healing, it’s important NOT to:

• touch or rub your eyes
• get water in your eye
• use eye makeup
• do heavy exercise
• be in places that are smoky or dusty

You may be given drops to use at home to help your eyes heal.

Here are some common side effects of cross-linking surgery:

• Feeling like something in your eye (called “foreign body sensation”)
• Being sensitive to light
• Having dry eye
• Having hazy or blurry vision
• Feeling eye discomfort or mild eye pain

Rarely, cross-linking can cause more serious side effects, including:

• worsening of keratoconus
• scarring
• infection
• loss of vision

Your vision will be very blurry at first but should gradually improve within two to three weeks.

If you have severe eye pain, or a sudden change/loss of vision, call your doctor immediately.

Recovery Time for Cross-linking

Ask your doctor when it’s safe to resume your normal activities. Most people are able to get back to their normal daily activities within 1-2 weeks of cross-linking.

Your vision may not be fully stable for several months. This means your “best-corrected” vision (your eye glasses or contact lens (scleral Lens Like ONEFIT MED Prescription) will likely change during this time. After six to eight weeks, your doctor will likely refit your glasses or hard contact lenses.

While cross-linking does not make your existing corneal bulging and thinning go back to normal, the goal of treatment is to keep keratoconus or ectasia from getting worse. For some people, cross-linking prevents the need for more serious surgery, like a corneal transplant.

Corneal transplant

When symptoms are severe, your ophthalmologist may suggest a corneal transplant. Your ophthalmologist replaces all or part of your diseased cornea with healthy donor cornea tissue.

Do not rub your eyes!

With keratoconus, try to avoid rubbing your eyes. This can damage thin corneal tissue and make your symptoms worse.

If you have itchy eyes that cause you to rub, speak to your ophthalmologist about medicines to control your allergies.

FOR CRISPY OR CLEAR VISION WITH NO GLARE AFTER C3R 

GO for a Sclera lens fitting with your Optometrist who will help for perfect vision with comfortable contact lens Scleral lens (ONEFIT MED) rather than the other hard lens.