Keratoconus is a progressive eye condition that affects the cornea, causing it to thin and gradually bulge into a cone-like shape. While it typically manifests during the teenage years or early twenties, it can affect individuals of any age. Understanding this condition, its symptoms, risks, and treatment options is essential for timely intervention and management.

Definition

Keratoconus is a non-inflammatory disorder of the eye where the cornea, the clear outer layer covering the front of the eye, progressively becomes thinner and more conical in shape. This irregularity disrupts the normal refractive properties of the cornea, leading to visual distortion and impairment.

Age Group Affected

Although keratoconus can affect individuals of any age, it commonly emerges during adolescence or early adulthood, with onset typically occurring between the ages of 10 and 25. However, cases have been reported in older and younger age groups as well. The youngest cases seen were 6-7 years old.

Pre-Requisites

While the exact cause of keratoconus is difficult to define, several factors may contribute to its development. These include genetic predisposition, environmental influences, and certain ocular conditions such as chronic eye rubbing or a history of poorly fitted contact lenses. Individuals with a family history of keratoconus are at a higher risk of developing the condition.

Symptoms

The symptoms of keratoconus often begin gradually and may initially go unnoticed. As the condition progresses, however, individuals may experience:

Dr. Puja Rai

MBBS,DNB (Ophthalmology),FCRS…MBBS,DNB (Ophthalmology),FCRS (Cornea & MicroSurgery)MBBS,DNB (Ophthalmology),FCRS (Cornea & MicroSurgery)
Specialist OphthalmologistSpecialist OphthalmologistSpecialist Ophthalmologist

  1. Blurred or distorted vision: As the cornea becomes more irregular in shape, it affects the eye’s ability to focus properly, resulting in blurred or distorted vision.
  2. Increased sensitivity to light (photophobia): Many individuals with keratoconus experience heightened sensitivity to light, making it uncomfortable to be in brightly lit environments.
  3. Frequent changes in prescription: Due to the progressive nature of keratoconus, individuals may require frequent changes in prescription eyeglasses or contact lenses to maintain adequate vision.
  4. Halos and ghosting: Keratoconus can cause halos or ghosting around lights, particularly at night, further impairing vision.
  5. Eye irritation and discomfort: Some individuals may experience eye redness, itching, or discomfort, often exacerbated by wearing contact lenses.

Risks If Not Treated in Time

If left untreated, keratoconus can lead to significant vision impairment and decreased quality of life. As the condition progresses, the cornea continues to thin and bulge, increasing the risk of complications such as:

  1. Corneal scarring: Severe cases of keratoconus may result in corneal scarring, further compromising vision.
  2. Hydrops: In rare instances, the thinned cornea may develop tiny breaks or tears, allowing fluid from inside the eye to enter the cornea. This sudden swelling, known as hydrops, can cause sudden vision loss and severe pain.
  3. Reduced visual acuity: Untreated keratoconus can significantly impair visual acuity, making everyday tasks such as driving or reading difficult or impossible.

Treatment

While there is currently no cure for keratoconus, several treatment options are available to manage the condition and improve visual function:

  1. Glasses or contact lenses: In the early stages of keratoconus, eyeglasses or soft contact lenses may be sufficient to correct mild to moderate refractive errors and improve vision.
  2. Rigid gas permeable (RGP) contact lenses: RGP lenses are often prescribed for individuals with keratoconus as they provide a smooth, rigid surface that helps to correct the irregular shape of the cornea and improve vision.
  3. Scleral lenses: These large-diameter contact lenses vault over the cornea and rest on the sclera (the white part of the eye), providing a more comfortable and stable fit for individuals with advanced keratoconus.
  4. Corneal cross-linking: Corneal cross-linking is a minimally invasive procedure that involves applying riboflavin (vitamin B2) eye drops to the cornea, followed by exposure to ultraviolet (UV) light. This treatment strengthens the corneal tissue and helps to slow or halt the progression of keratoconus.
  5. Intacs: Intacs are small, arc-shaped implants that are surgically inserted into the cornea to flatten its curvature and improve vision in individuals with keratoconus.
  6. Corneal transplant: In severe cases of keratoconus where other treatments are ineffective, a corneal transplant may be necessary. During this procedure, the damaged cornea is replaced with a healthy donor cornea.

Conclusion

Keratoconus is a progressive eye condition that can have a significant impact on vision and quality of life if left untreated. Early detection and intervention are crucial for managing the condition and preserving vision. By understanding the symptoms, risks, and treatment options available, individuals with keratoconus can take proactive steps to protect their eye health and maintain optimal vision for years to come.