Keratoconus
What is Keratoconus?
Keratoconus is a progressive disease of the cornea; which is the visible transparent front layer of the eye; causing thinning and conical bulging of cornea. The reasons for this disease are unknown. It is seen in 1/2000 of society and also seen in 5-15 % of people with Down syndrome. It is typically seen in adolescents in their late teen ages and early twenties. Keratoconus disease is thought to be a combination of genetic predisposition and environmental factors; that we call epigenetic causes. Although it is not considered a hereditary disease, in some families it can be seen in more than in one individual. Keratoconus is also seen in people with atopic conditions along with the history of itching and rubbing of the eyes especially during childhood.
Symptoms of Keratoconus
The main symptom of Keratoconus is the progressive impairment of vision that cannot be corrected with glasses and soft lenses.
The presence of rapid progressing myopic astigmatism detected by your ophthalmologist may be a sign of Keratoconus and it is important to perform detailed studies for early diagnosis. Corneal Topography taken in the early stage of this disease is very important in term of diagnosis.
In Keratoconus Disease: along with progressive myopic astigmatism, irregular astigmatism develops in the cornea and due to this, conical bulging and thinning of the cornea develops.
Early diagnosis is important in order to preserve your vision. Vision can be corrected in early stage with glasses and contact lenses. But for patients with progressed stages; irregular astigmatism with the increased conical bulged cornea; correction of vision with glasses will not be possible anymore. In those cases improving vision is just possible either with hard lenses and/or hybrid lenses. As the Keratoconus disease is a progressive disease it can’t be stopped by using glasses and lenses.
Moreover; with the increase of vision loss; patients with Keratoconus endeavour problems and have complaints with scattered lights, halos, sensitivity to lights, eye fatigue, eye and headache, and find it hard to drive at night time.
Treatment of Keratoconus
Corneal Collagen Cross-Linking (UV-Cross linking)
The only treatment option that can stop Keratoconus disease from progressing is Corneal Collagen Cross-Linking. The earlier the diagnosis and the treatment the more vision accuracy is preserved.
For Corneal Cross Linking Treatment; vitamin Riboflavin (B2) is dripped onto the surface of the cornea. UVA light is used to stimulate the formation of extra ligaments between the corneal collagen cells to increases the stability and strength of the cornea.
In early stage of Keratoconus the Collagen Cross-Linking can be combined with topographic surface eye laser treatment. With that treatment combination Keratoconus is stopped and the quality of vision is will be improved.
Ring Treatment Inside the Cornea
With the Femtosecond Laser grooves are created inside of the cornea in which special rings are placed which causes flattening of the conical bulged cornea.
Cornea Transplant
Increased awareness of Keratoconus and early diagnosis will reduce the need for corneal transplant in the future. Cornea Transplant is the treatment method for advanced stages of Keratoconus. For corneal transplantation the weak cornea of the patient is replaced with a healthy cornea from a donor. The cornea itself is build up of different layers. 2 different transplant methods existing: While with the “Penetrating Keratoplasty (PK)” all layers of the cornea are removed from the patient’s eye and are replaced with all layers from the donor’s cornea; with the “DALK” method just the front layers of the patient’s cornea are replaced with the front layers from the donor’s cornea.