Keratoconus is a corneal disease where the cornea thins and changes shape, forming a cone. This distortion significantly impacts vision, making everyday tasks like reading, driving, and recognizing faces difficult. Without treatment, the condition can progress to severe vision loss.
Fortunately, advancements in medical science offer effective treatments for keratoconus. These treatments aim to correct vision and halt or even reverse the progression of the disease. In this blog, we'll explore these innovative approaches, how they work, and what they mean for individuals with keratoconus.
What is Keratoconus?
Keratoconus is a non-inflammatory, degenerative disease affecting both eyes (bilateral). It primarily involves the cornea, the clear outer layer of the eye. The cornea loses its normal round shape and progressively bulges outward in a cone-like structure due to corneal weakening.
This change in shape distorts light entering the eye, leading to blurred or distorted vision. Individuals with keratoconus may experience photophobia (light sensitivity), difficulty with night vision, and frequent changes in their eyeglass prescriptions.
The exact cause of keratoconus remains unknown, but it is believed to have both genetic and environmental components. Therefore, regular eye examinations with an ophthalmologist or optometrist are crucial for early diagnosis and treatment before the condition worsens.
Traditional Treatments for Keratoconus
Until recent years, the only approaches to managing keratoconus have been to treat the symptoms, not the disease itself. These included:
1. Prescription Glasses and Soft Contact Lenses
These solutions were effective in the early stages, improving distorted vision but not preventing disease progression.
2. Rigid Gas Permeable (RGP) Lenses
These corrected vision by reshaping the cornea but often caused discomfort.
3. Intacs (Corneal Inserts)
Intacs are small, crescent-shaped plastic inserts surgically implanted into the cornea to reshape and flatten it. While successful in some cases, Intacs had limitations, particularly in more advanced keratoconus.
These methods provided limited relief in some cases and could not prevent the condition from worsening
Latest Advances in Keratoconus Treatment
Modern medicine has introduced several advanced treatments that are transforming how keratoconus is managed. These approaches focus on both improving vision and halting the condition’s progression, offering hope to patients at all stages.
1. Corneal Cross-Linking (CXL)
Corneal cross-linking is one of the biggest advancements in the treatment of keratoconus in the recent past. It entails the use of a solution containing a form of vitamin B2 known as riboflavin and then the cornea is subjected to ultraviolet UV light.
How it Works:
This treatment encourages the formation of new collagen fibers in the cornea, something that makes the cornea stronger and less likely to become any thinner.
Types of CXL:
- Epithelium-On (Epi-On): This less invasive procedure promotes faster healing.
- Epithelium-Off (Epi-Off): This more invasive treatment may be more effective for advanced cases.
It is most effective for patients in the early stages of the disease because CXL can prevent the further deterioration of keratoconus and save the patient’s vision.
2. Customised Contact Lens Technology
Technological advancements have led to significant improvements in contact lenses, making them more suitable for individuals with keratoconus
- Scleral Lenses: These large-diameter lenses rest on the sclera (the white part of the eye), vaulting over the cornea to provide clear vision and improved comfort.
- Hybrid Lenses: These lenses combine the clarity of rigid gas permeable lenses with the comfort of soft lenses, making them a good option for those who have difficulty with traditional lenses.
Custom-designed glasses that accommodate the irregular shape of a keratoconus-affected cornea can improve vision and comfort
3. Topography-Guided Treatments
Corneal topography, which maps the surface of the cornea, enables precise treatment planning.
- This technology is used to plan laser-guided procedures and optimize contact lens fitting.
- Customized treatments help address the unique corneal characteristics of each patient, leading to improved visual outcomes.
4. Improved Corneal Transplant Techniques
In cases where other therapies are not useful any longer, corneal transplants may be required for individuals with Keratoconus.
- Deep Anterior Lamellar Keratoplasty (DALK): A procedure where only the diseased layers of the cornea are removed and replaced with healthy donor tissue.
- Penetrating Keratoplasty (PK): A full-thickness corneal transplant, used for advanced keratoconus when other procedures are not suitable
Modern techniques in the surgical approach to the area have provided shorter periods of recovery, and higher success rates of vision improvement by the patient.
5. Emerging Research in Gene Therapy
There are many aspects of gene therapy that could help change the future of keratoconus treatment for the better. Researchers are also trying to find out how to fix the genetic roots of the condition so that they may be prevented or reversed. Although this approach is still in development, it has a lot of potential for future use.
Who Can Benefit from These Treatments?
The most recent developments in the management of keratoconus address the needs of patients with primary to tertiary disease. The sooner the diagnosis is made the better treatment options are available. An eye doctor can advise you on how often you should have an eye check-up and whether you need to consult an ophthalmologist.
Keratoconus is no longer a lifetime of having to deal with poor eyesight. There are however current approaches to the management and even the reversal of this condition with the help of modern technology. From corneal cross-linking to custom lenses, or new surgical approaches, everything is now available to provide hope and vision to those who need it.
You should not let keratoconus limit you. The first step towards improved vision, therefore, is to seek advice from an expert. Make your appointment with The Eye Foundation today.
