WHAT IS KERATOCONUS?

The cornea is the furthest front transparent tissue of the eye. Thanks to its refracting power in combination with that of the lens the light focuses on the retina. The eye looks like a camera: it is equipped with a lens of a certain optical power /cornea and lens/ and light-sensitive photographic film /retina/. Keratoconus is an eye disorder when the cornea progressively deforms ,gets thinner and eventually changes to an irregular conical shape. The result of this process is irregular corneal astigmatism, which is hard /sometimes impossible/ to correct by glasses or contact lenses.

The visual acuity decreases. The frequency of the disorder is approximately 1:2000, both sexes are affected equally. Symptoms usually occur in the youth years /16-30 years of age/ when prescribed glasses or contact lenses are periodically changed. In about 15-20% of the cases the condition may lead to corneal transplantation /penetrating keratoplasty/ that will improve, to a certain extent, the visual acuity.

What are the complaints?

  • blurred vision
  • frequent change of the prescriptions of glasses
  • ncreasing shortsightedness
  • astigmatism

Does keratoconus combine with any other disorders? It is considered that it is linked to hay fever, bronchial asthma, eczemas, mitral insufficiency, Down syndrome and Marfan syndrome, loose joints.

What causes this disorder?

The causes are still unknown but most probably they are genetic. It is certain that some of the cases are hereditary, with about 8% of the patients with keratoconus having blood relatives with similar changes and complaints. If there are no other patients with keratoconus in the family the likeliness for the children of such patient to develop this degenerative disorder of the connective tissue is about 10%.

Yes, it does. Solely, in very small proportion of the population /under 1%/ only one of the eyes is affected.
Usually, the changes in the cornea are asymmetric; one of the eyes may be much more deformed and may be getting much thinner than the other one.

The initial symptoms are blurred vision and frequent change of the prescriptions of glasses or lenses with increasing shortsightedness and astigmatism.

WHEN IS THE TIME FOR SURGICAL TREATMENT?

At the early stages constantly changing astigmatism and shortsightedness is corrected by glasses or contact lenses. Usually, soft contact lenses are not suitable because they cannot correct the irregular astigmatism. In about 15-20 % of patients corneal transplantation is necessary.

This treatment is the actual crosslinking of corneal collagen fibrils with riboflavin and exposure to ultraviolet light. It involves removing the uppermost corneal layer /corneal epithelium/ followed by dripping Riboflavin drops. The eye is exposed to ultraviolet light for 30 min. Then a soft contact lens or an eye pad is put for 4-5 days until the stripped corneal stroma is covered again with epithelium and the unpleasant feel, running and reddishness of the eye abate. Antibiotic drops or eye gel are use.

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