So, what is keratoconus? At its core, keratoconus is a progressive eye disorder where the normally round cornea, which is the clear, dome-shaped front surface of your eye, begins to thin and bulge into a cone-like shape.
This irregular shape deflects light as it enters the eye, leading to distorted vision. The term keratoconus itself comes from the Greek words kerato, meaning cornea, and konos, meaning cone, describing the characteristic conical shape of the cornea in this condition.
Causes of keratoconus
Gaining insight into the causes of keratoconus is crucial for understanding how to manage the condition and explore effective Keratoconus treatment options.
Although the precise cause of keratoconus remains somewhat unclear, various factors are thought to play a role in its development.
For those living with keratoconus, it’s important to be aware of these contributing factors to better manage and potentially slow the progression of the condition. Here’s an in-depth look at the primary causes:
Genetic predisposition
One of the most significant factors linked to keratoconus is genetics. If you have a family history of keratoconus, your chances of developing the condition are considerably higher.
Studies have shown that keratoconus often runs in families, which suggests a strong genetic component. Specific genes may be responsible for weakening the corneal structure, making it more susceptible to the thinning and bulging characteristic of keratoconus.
However, not everyone with a family history of the condition will develop it, indicating that other factors also play a role.
Chronic eye rubbing
Chronic eye rubbing is another well-documented cause of keratoconus. This behaviour is often associated with allergies, eye irritation, or conditions like atopic dermatitis, where the eyes are frequently itchy.
Rubbing your eyes vigorously can cause micro-traumas to the corneal tissue, leading to its gradual weakening and thinning.
Over time, this repeated trauma can contribute to the development and progression of keratoconus. It’s crucial to manage underlying conditions like allergies to reduce the urge to rub your eyes and protect the integrity of your cornea.
Systemic conditions
Certain systemic conditions, particularly those involving connective tissue disorders, have been linked to an increased risk of keratoconus.
Conditions like Marfan syndrome, Ehlers-Danlos syndrome, and Down syndrome are known to affect the body’s connective tissues, including the collagen fibres that provide structure and strength to the cornea.
In these disorders, the corneal tissue may be inherently weaker, making it more prone to the thinning and bulging that occurs in keratoconus. This connection highlights the importance of considering overall health when assessing the risk for keratoconus.
Symptoms of keratoconus
Keratoconus is a progressive eye condition that alters the shape and clarity of your cornea, resulting in a range of visual symptoms.
For those living with keratoconus, these symptoms can differ significantly depending on the stage of the disease and often develop gradually over time.
Understanding these symptoms is crucial for seeking appropriate Keratoconus treatment. Here’s an in-depth look at the common symptoms associated with keratoconus:
Blurry vision
One of the earliest and most common symptoms of keratoconus is blurry vision. As the cornea begins to thin and bulge into a cone shape, the smooth, regular curvature of the cornea is disrupted.
This irregular shape causes light entering the eye to be unevenly focused, leading to blurred vision. Initially, this blurriness might be mild and easily mistaken for a simple refractive error like myopia (nearsightedness) or astigmatism.
However, as keratoconus progresses, the blurring typically worsens and becomes more difficult to correct with standard glasses or contact lenses.
Distorted vision
Distorted vision is another hallmark of keratoconus. Because the cornea is no longer uniformly curved, the light entering your eye is scattered in different directions. This can cause objects to appear misshapen or wavy.
For instance, straight lines might look bent or warped, and you might experience ghosting, where multiple images appear overlapping, especially when looking at high-contrast objects like text on a page.
This distortion can make tasks that require clear vision, such as reading or driving, particularly challenging.
Increased sensitivity to light (photophobia)
As keratoconus progresses, you may find yourself becoming increasingly sensitive to light, a condition known as photophobia. Bright lights, such as sunlight or indoor lighting, can cause discomfort or glare, making it difficult to see clearly.
This sensitivity is often exacerbated by the irregular surface of the cornea, which causes light to scatter more within the eye. Photophobia can be particularly troublesome when driving at night or in environments with fluctuating lighting conditions.
Eye irritation or discomfort
Keratoconus can also lead to general eye irritation or discomfort. The constant strain of trying to focus with distorted vision can leave your eyes feeling tired or strained.
Additionally, the irregular surface of the cornea may cause issues with contact lens fit, leading to discomfort or irritation. In some cases, the eye may feel itchy or dry, further contributing to discomfort.
Managing this irritation often requires careful attention to eye hygiene and the use of lubricating eye drops or other soothing measures.
Difficulty with night vision
Night vision tends to worsen as keratoconus progresses. The scattering of light caused by the irregular cornea is more pronounced in low-light conditions, making it harder to see clearly at night.
You might notice that driving at night becomes more challenging due to glare from oncoming headlights, halos around streetlights, and an overall reduction in visual clarity.
This difficulty with night vision can be one of the more disabling symptoms of keratoconus, affecting your confidence and safety in low-light environments.
Eye strain or fatigue
Living with keratoconus often means dealing with eye strain or fatigue, especially after prolonged visual tasks like reading, working on a computer, or driving. The constant effort required to focus and compensate for distorted vision can leave your eyes feeling tired and achy.
This strain is compounded by the frequent changes in vision, which can make it hard to find the right corrective lenses and may leave you struggling to see clearly even with glasses or contacts.
Over time, this eye strain can contribute to headaches and general fatigue, further affecting your quality of life.
Treatment of keratoconus
When it comes to Keratoconus treatment, the approach largely depends on the severity of your condition and how much it’s impacting your daily life.
Contact lenses
In the early stages, glasses or soft contact lenses may be sufficient to correct your vision. However, as keratoconus progresses and the cornea becomes more irregular, more specialised treatments may be required.
Rigid gas permeable (RGP) lenses are often the next step in Keratoconus treatment. These lenses are made from a firm, durable material that holds its shape on the eye, providing a smooth surface to improve vision.
For those who struggle with RGP lenses, hybrid lenses, which combine a hard centre with a soft outer ring, or scleral lenses, which are larger and vault over the entire cornea, might be more comfortable and effective.
Corneal cross-linking (CXL) is a relatively new and groundbreaking procedure that can halt the progression of keratoconus. This treatment works by strengthening the corneal tissue through the application of riboflavin drops, which are then activated by UV light.
This process creates additional bonds between the collagen fibres in the cornea, making it stiffer and less likely to bulge. For many people, CXL can significantly reduce the need for more invasive treatments later on.
Corneal transplant
In more severe cases, where the cornea has become extremely thin or scarred, a corneal transplant may be necessary. This procedure involves replacing the damaged cornea with healthy donor tissue.
There are different types of corneal transplants, ranging from full-thickness transplants (penetrating keratoplasty) to partial-thickness transplants (lamellar keratoplasty), depending on the extent of the damage.
While a corneal transplant can restore vision, it’s a major surgery with risks, including graft rejection and infection, and it requires a lengthy recovery period.
Wrap-up
Keratoconus is a complex and often challenging condition, but with the right knowledge and resources, you can manage it effectively.
By understanding what is keratoconus and the range of Keratoconus treatment options available, you’re better equipped to make informed decisions about your eye health.
Whether you’re in the early stages or facing more advanced symptoms, remember that living with keratoconus is about finding a balance between medical treatment, lifestyle adjustments, and emotional support.
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