Keratoconus

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Keratoconus

What is keratoconus?

Keratoconus is an eye disorder in which the central or paracentral area of the cornea progressively thins. The cornea's usual spherical shape becomes conical, leading to irregular astigmatism, which distorts images and causes a decrease in vision.

  • Keratoconus is one of the main reasons for corneal transplantations in young patients.

What causes it?

  • Genetic factors: Keratoconus is inherited in about 25% of cases, with the remaining cases appearing sporadically. These patterns of inheritance are complex and are the subject of ongoing research.
  • Environmental factors: The disorder can also be linked to eye allergies or continuous rubbing of the eyes.

How can it be prevented?

There are no preventative measures for keratoconus. However, there are treatments available to arrest its development:

  • Early detection is essential to prevent the condition from progressing and requiring a corneal transplant.
  • Mild forms of keratoconus may not cause visual impairment and can only be diagnosed through topographic examination.
  • Relatives of patients with keratoconus, even if they do not show symptoms, should undergo a visual examination, as they may be carriers of the disease.
  • Regular eye exams are recommended for children and young people, who are most at risk for the condition.

Symptoms

The primary symptoms of keratoconus include:

  • Decreased vision
  • The sudden onset or increase of astigmatism, which is induced by a refractive defect in the cornea.
  • Astigmatism in keratoconus does not naturally develop with age, making it important to perform a topographic examination if there is a sudden change in vision, especially in children or young people.

Associated treatments

Treatment options depend on the severity of the disease:

  • Mild cases: Good vision can often be achieved with glasses.
  • Advanced cases: Hard contact lenses are required to correct the irregular astigmatism.
  • Surgical options: In some cases, surgery may be necessary, such as:
    • Intrastromal corneal rings: Used to stabilize the cornea.
    • Corneal cross-linking: A highly effective procedure that slows down the progression of keratoconus.
  • Severe cases: When vision has significantly reduced, the only solution may be keratoplasty (corneal transplantation). In modern procedures, transplantation may involve selectively replacing the affected layers of the cornea, preserving healthy tissue.

Surgical treatments for keratoconus:

  • Intrastromal corneal rings
  • Femtosecond laser
  • Corneal cross-linking
  • Penetrating or lamellar corneal transplantation