We see through our cornea, the clear bit of the front surface of the eye. It is normally round, shaped like a ball. Sometimes, the cornea’s structure weakens and is no longer strong enough to stay in this rounded shape. Over time, the eye’s surface bulges out, and its shape becomes more like a cone.
Keratoconus can change our vision in two ways:
The main symptoms of keratoconus are:
Patients notice that their vision becomes distorted slowly, a change that can end at any time or continue for years. Both eyes are usually affected. Keratoconus is usually detected in people in their late teens or 20’s. It can also begin in childhood, when it appears at a more rapid rate, or later in life, when it is usually mild.
The exact cause of keratoconus is unknown, and there are no eye diseases or injuries that explain why the changes begin to occur. Some research has shown that keratoconus might run in families and occurs more often in people with certain medical conditions. People with keratoconus often rub their eyes more, which may speed up the development of the condition.
To diagnose keratoconus, a doctor must first measure the curvature of the cornea. Several diagnostic tests can confirm a diagnosis, with the test used most often being topography. This measures the curvature of the eye’s surface and gives a colored “map” of the cornea. In patients with keratoconus, there are very distinctive changes in these maps, which confirm a diagnosis.
Keratoconus can cause permanent vision loss if it is not treated. The changes to the cornea’s shape make it difficult for the eye to focus, even with the help of glasses. Corrective laser vision surgery can also be dangerous for anyone with any degree of keratoconus, as it can make the condition worse.
Treatment for keratoconus will depend on how severe the condition is. If it is in the earliest stages, glasses or soft contact lenses can correct vision. As keratoconus develops, and the irregular astigmatism worsens, glasses may not work, and a hard contact lens may need to be fitted.
Some patients may be candidates for treatments called implantable ring segments or corneal crosslinking:
In very severe cases, a cornea transplant may be recommended, in which a patient’s cornea is replaced with one from a donor.
Procedures such as INTACS and corneal cross-linking are very effective at slowing down or stopping keratoconus, especially in younger patients. These advances can minimize vision loss and many patients will never need a transplant. In severe cases, or for people who aren’t candidates for these procedures, corneal transplants offer improved vision, and glasses or special lenses may still be required to provide the best vision possible.
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Cleveland Clinic Abu Dhabi recommends routine eye examinations to help prevent vision loss.
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This information is provided by Cleveland Clinic Abu Dhabi, part of Mubadala Healthcare, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
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