Keratoconus
Keratoconus is an eye condition where the normally round, dome-shaped cornea (the clear front surface of the eye) gradually thins and bulges outward into a cone shape. This irregular shape can distort vision and make everyday tasks like reading or driving more difficult.
Causes
The exact cause isn’t fully understood, but several factors may play a role:
- Genetics (family history of keratoconus)
- Chronic eye rubbing
- Underlying conditions like allergies, asthma, Down syndrome, or connective tissue disorders
- Oxidative stress that weakens the corneal tissue
Symptoms
- Blurred or distorted vision
- Increased sensitivity to light and glare
- Frequent changes in glasses prescription
- Difficulty seeing at night
- Eye strain or headaches
- Often affects both eyes, but one eye may be worse
Symptoms usually begin in the late teens to early 20s and may progress over 10–20 years.
Diagnosis
- Comprehensive eye exam
- Corneal topography: A special scan that maps the shape of the cornea (most accurate way to diagnose keratoconus)
- Pachymetry: Measures corneal thickness
- Slit-lamp exam to check for corneal thinning or scarring
Management
Early/Mild Cases:
- Eyeglasses or soft contact lenses to correct vision
Moderate Cases:
- Rigid gas permeable (RGP) or scleral contact lenses to improve focus by creating a smooth surface
- Hybrid lenses (hard center with soft edges) for comfort and clarity
To Slow or Stop Progression:
- Corneal Collagen Cross-Linking (CXL) - A minimally invasive procedure that strengthens the cornea using vitamin B2 (riboflavin) drops and UV light. This can halt progression but doesn't reverse damage.
Advanced Cases:
- Corneal transplant (keratoplasty) may be needed if scarring or thinning becomes severe and vision cannot be corrected with lenses
Prevention Tips
- Avoid eye rubbing—it can make keratoconus worse