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Keratoconus

Keratoconus

What is Keratoconus?

Keratoconus is a condition in which the protein fibers that make up the cornea weaken, preventing the cornea from maintaining its shape. When this happens, the cornea (usually sphere-like in shape) can bulge in a cone-like shape and alter the way light enters the eye, causing visual distortion.

These changes to the cornea make it difficult for the eye to focus on its own, and typically require vision correction with a hard contact lens.

It is important to note that laser vision correction surgery – LASIK or PRK – can be dangerous for people who have keratoconus.

With Keratoconus, the cornea bulges to a cone shape, causing distorted vision. Image © 2009 by the American Academy of Ophthalmology.

With keratoconus, the cornea bulges to a cone shape, causing distorted vision. Image © 2009 by the American Academy of Ophthalmology.

 

  • Causes of Keratoconus
  • Symptoms of Keratoconus
  • Diagnosis of Keratoconus
  • Treatment of Keratoconus

The cause of keratoconus is unknown, but many believe genetics may play a factor. Image © 2009 by the American Academy of Ophthalmology.

The cause of keratoconus is unknown, but many believe genetics may play a factor. Image © 2009 by the American Academy of Ophthalmology.

While the causes of keratoconus are not entirely known, many doctors believe that genetics may play a part, since kerataconus tends to run in families. In fact, 10 percent of people with keratoconus have a family member who also has the condition.

Other factors that may play a role in the development of keratoconus include:

  • Excessive (chronic) eye rubbing
  • Injury to the eye
  • Long-term wear of hard contact lenses
  • Certain eye diseases, including retinitis pigmentosa, retinopathy of prematurity and vernal keratoconjunctivitis
  • Certain systemic conditions, including Down syndrome
  • Certain allergic conditions

Because keratoconus appears to run in families, it’s important to have your children’s eyes checked if you have the disease. Keratoconus typically begins in the teenage years, but can also occur in children or adults up to age 30. Rarely, the condition occurs in people 40 and older.

Keratoconus can make wearing contact lenses virtually impossible.

Keratoconus can make wearing contact lenses virtually impossible.

Individuals with keratoconus usually begin to notice symptoms in their late teens or early 20s, often in both eyes simultaneously. The early symptoms of keratoconus can often mirror other eye conditions, such as myopia or cataracts.

These symptoms include:

  • Mild blurring of vision
  • Sensitivity to light

However, with keratoconus, additional early symptoms include:

  • Distortion of vision, in which straight lines look wavy
  • Eye irritation, including redness or swelling

As keratoconus progresses (often over 10 to 20 years), individuals affected with the disease may notice:

  • Increased blurriness of vision
  • More distortion in vision
  • Double vision when one eye is closed
  • Glare, halos or streaking around lights
  • Frequent change in eyeglass prescription
  • Inability to wear contact lenses due to pain

While keratoconus typically advances slowly, some people may notice the disease advancing quickly, with sudden swelling of the cornea and development of scar tissue. When this occurs, the cornea clouds even more quickly and vision is distorted even further.
PC2Like many eye diseases, keratoconus is diagnosed through a routine eye exam by an ophthalmologist. The presence of keratoconus and its staging is best assessed by computerized corneal mapping, in which a three dimensional representation of the cornea is created and analyzed.

At Parker Cornea, we use the highest resolution Pentacam HR to map the front and back surface of the cornea and objectively assess the cornea’s clarity and optical properties.

Intacs are small, curved surgical implants that are placed just underneath the periphery of the cornea to help it maintain its proper shape. Image © 2009 by the American Academy of Ophthalmology.

Intacs are small, curved surgical implants that are placed just underneath the periphery of the cornea to help it maintain its proper shape. Image © 2009 by the American Academy of Ophthalmology.

No treatment for keratoconus will perfectly restore the cornea to its normal shape, so the best treatment is to stop the progression of the disease as quickly as possible. Fortunately, corneal collagen cross-linking appears to do just that and is expected to receive FDA approval imminently. Cross-linking treatment should be strongly considered as soon as keratoconus is diagnosed. Visual disturbance in mild cases of keratoconus can be corrected with a hard contact lens, but as the condition progresses, additional treatments may be required, including Intacs, Bowman Layer transplantation or partial or full-thickness corneal transplantation. Click each link to learn more.