Keratoconus is a disease that causes the cornea to progressively thin. This condition causes the normal outward pressure from within the eye to begin to shape and bulge in a cone-like shape. A healthy eye is spherical shaped allowing images to focus clearly, with keratoconus, due to the cone-like shape, images are distorted. This condition affects both eyes; however, it is known to progress at different rates in each eye. Although the condition rarely results to blindness, it can cause vision impairment and a corneal transplant may be needed, up to 20% of the time.
Keratoconus affects one in 2,000 people and symptoms typically begin during teenage years and worsen before stabilizing within your early 30s or 40s. While there are no proven studies that show where keratoconus originates from, evidence sates that the condition may be genetic.
Different types of keratoconus contact lenses are used for keratoconus treatment. Keratoconus contact lenses have advanced technology and offer comfortability and excellent vision. In early stages of keratoconus, soft contact lenses can correct the astigmatism. However, as the condition worsens, more rigid contact lenses such as gas permeable (RGP) lenses may be required to manage the condition.
Specialized, custom contact lenses have been developed for keratoconus vision correction, however most practioners manage the condition with rigid contact lenses (RGP’s), as finding an experienced contact lens fitter with experience in managing patients with this condition can be challenging.
There are different keratoconus contact lenses that can help correct vision in patients such as soft, rigid gas permeable, scleral, and hybrid lenses. The more commonly used keratoconus contact lenses are the soft and RGP. These soft and RGP lenses offer a new refractive surface for the eye while catering to comfortability. Less prescribed keratoconus contact lenses are scleral and hybrid lenses. Scleral keratoconus contact lenses are larger in diameter and rest on the white portion of the eye. The massive size in the lenses often discourages patients from using the product. Although the size of the lenses is alarming, these keratoconus contact lenses are proven to be more comfortable and decrease the risk of dirt and particles from entering underneath the lenses.
While keratoconus contact lenses are commonly prescribed, there are other keratoconus treatment options for those with more advanced cases.
Intacs corneal inserts or implants are a minimally invasive surgical option to treat keratoconus in patients where vision correction can no longer be achieved with contact lenses or eyeglasses. Intacs are micro-thin prescription corneal inserts that were previously used to treat myopia and nearsightedness but have been recently approved by the FDA for keratoconus treatment. These semi-circular rings are inserted into the mid layer of the cornea. Upon insertion, the ring is utilized to flatten the cornea and to change the shape and location of the cone. These rings can correct some or all of the irregularities caused by the eye disease and as patients age, they have the option of replacing them with newer rings as their prescription changes.
For those patients whose keratoconus condition has progressed to a point where vision correction is no longer possible with eye glasses, contact lenses or Intacs, a corneal transplant may be necessary to treat the condition. The central damaged portion of the cornea is surgically removed from the eye and a healthy donor cornea is grafted to the existing eye tissue using sutures. Corneal transplant surgery is usually a last result in keratoconus treatment and can occasionally result in the body naturally rejecting the donor tissue. Rejection of the donor tissue can happen even months after the surgery.
Every patient experiences keratoconus differently and the disease can progressively worsen as patients age. Routine comprehensive eye exams are essentially important in treating the progression of keratoconus as the condition can occur during your teen years and can be prevented from worsening, if caught at an early stage.