JOIN USKERATOCONUS Dr Balakrishna Shetty tells you about a lesser-known eye illness, which is known to affect quite a few teenagers and young adults.
Keratoconus is a progressive eye disorder which usually begins in the teenage or early adulthood and may occur in one or both the eyes. In keratoconus, the normally round, dome-shaped cornea becomes thin and develops a cone-like bulge, causing distortion in vision. The condition makes certain activities like driving and working on a computer difficult and even risky.
In its earliest stages, keratoconus causes slight blurring, distorted vision and heightened sensitivity to glare and light. Frequent changes in eyeglass prescription is another common and early symptom of keratoconus. Yet it may take years before the condition gets diagnosed.
A number of factors have been attributed to causing keratoconus. However, till date, no specific reason has been identified behind its occurrence. Having certain inherited diseases or genetic conditions such as Down syndrome and a family history of keratoconus increase the chances of developing the disorder. It is recommended that parents with keratoconus must get their children regularly screened for the disorder right from their teen years. Depending upon the severity of keratoconus, a number of treatment modalities are available, which include:
Rigid contact lenses: If keratoconus is diagnosed early, the most common treatment is the use of rigid contact lenses.They correct the irregularity of corneal structure, thereby allowing the patient to have better quality vision. One must make sure to get the rigid lenses fitted by an eye specialist as ill-fitting hard lenses can further damage the cornea. Moreover, regular check-ups are essential for refitting or resizing of the lenses.
Corneal collagen cross-linking: It is based on collagen cross-linking with ultraviolet A and riboflavin (Vitamin B2, a photosensitising agent).This alters the intrinsic biomechanical property of the cornea, enhancing its strength by almost 300 percent. This increase in corneal strength has been shown to arrest the progression of keratoconus.
Intacs: They are thin, plastic, semi-circular rings, which are inserted into the mid layer of the cornea. These corneal inserts or implants flatten and correct the corneal bulge and improve vision. Intacs are a minimally-invasive surgical option for the treatment and are designed for long-term vision correction. They are very effective in treating mild and moderate cases of keratoconus. However, depending upon the severity of the condition, the patient may also require to wear spectacles or contact lenses for functional vision.
Corneal transplant: This is a surgical procedure, reserved for severe cases where vision cannot be improved by other treatments. It involves replacing the scarred and damaged cornea with the donor cornea.
(The author is senior ophthalmologist & chairman, Devi Eye Hospital, Bengaluru)