It’s possible that you’ve heard an eye doctor mention keratoconus, but what is keratoconus eye disease and why is it a concern? Let’s take a closer look.
What Is Keratoconus?
If you’ve been told you have keratoconus, you probably want to know more about it. So what is keratoconus eye disease and what causes it? Keratoconus is an eye disease in which the cornea thins abnormally, resulting in bulging in the front surface of the cornea. Unfortunately, the causes of this eye disease are not yet fully understood. There is some research indicating it could be caused by the disruption of normal levels of certain enzymes and other important substances that influence inflammatory responses within the cornea. However, known risk factors include allergies, frequent eye rubbing, and heredity.
For most patients, keratoconus develops during their teen years or early 20s and can impact just one eye or both eyes. When keratoconus goes untreated, it is progressive, causing vision problems that are difficult to correct with glasses or regular contact lenses. Thankfully, if caught early, keratoconus can often be treated to prevent further vision loss in the future.
What is Keratoconus: Symptoms
Now that you can answer “what is keratoconus,” symptoms are likely your next order of business. Understanding the symptoms of this eye disease can help you get an early diagnosis so you get treatment as soon as possible to preserve your vision. The early symptoms of keratoconus can include:
- Distorted vision, causing straight lines to look wavy or bent
- Eye redness or swelling
- Increased glare and light sensitivity
- Mild vision blurring
If you notice these symptoms, it’s important to get your eyes checked as soon as possible. If the disease progresses, later stage symptoms of keratoconus can include:
- Increased vision blurring and distortion
- Increased astigmatism or nearsightedness
- Inability to comfortably wear contact lenses that previously fit properly
- Sudden clouding or worsening vision
So what is keratoconus progression like? It typically progresses from early (stage 1) to late stage (stage 4) over the course of years. However, some patients experience faster progression due to swelling corneas that scar and further distort vision. As such, any symptoms of keratoconus should be assessed by your eye doctor as soon as possible.
How is Keratoconus Diagnosed?
What is keratoconus diagnosis like? Your ophthalmologist can diagnose keratoconus during a routine eye exam by looking at the shape and curvature of your cornea. Exams can involve:
- Keratometry, during which a circle of light is focused on your cornea and the reflection is measured to determine your corneal shape
- Refraction exams where you’ll look through different lenses to find the combination that gives you the best vision, or the doctor uses a retinoscope to check your eyes
- Slit-lamp exam, involving a vertical beam of light directed at your eye while the doctor uses a microscope to evaluate the shape of your cornea and identify other problems
For the most exact results, your surgeon may map your cornea using corneal tomography and topography to record the shape and thickness of your cornea. They may also use technology called wavefront mapping to get a clear picture of your optic system and identify higher order aberrations.
Keratoconus Treatment
Keratoconus is progressive, so treatment depends on the severity of the disease. If caught early, proper treatment can slow the progression of the disease. However, regardless of when keratoconus is identified, treatment will also focus on improving vision. So, what is keratoconus eye disease treatment like?
Early treatment options
If your keratoconus is identified in the mild to moderate stages, glasses or soft contact lenses may still be effective for correcting your vision. Your prescription will change, however, as your corneas change shape. In stages 1-3 of keratoconus, a special type of implantable ring segment device called INTACS can also be surgically implanted in your cornea to flatten the curve of your cornea. This makes fitting patients with contact lenses easier as well.
Your eye doctor may also suggest corneal collagen cross-linking to slow, or even stop, the progression of your disease. This treatment option stiffens the cornea to stabilize it and prevent further changes in shape, which can also prevent the need for a corneal transplant down the road. However, corneal collagen cross-linking does not improve your vision or reverse keratoconus, so it’s important to know that you’ll still need some vision correction.
Later stage treatment options
More advanced stages of keratoconus may require hard contact lenses called rigid gas permeable lenses for vision correction. These can be made to fit your corneas, though they can be uncomfortable at first. If you can’t tolerate them, your doctor may suggest “piggybacking” your hard contacts on top of soft contact lenses for greater comfort. Hybrid lenses may also be an option, as they’re hard in the center with a softer ring around the edges. If your corneas have become extremely irregularly shaped, scleral lenses can help. These contact lenses rest on the white of the eye (called the sclera) and go over top of your cornea without touching it. If you’re using hard or scleral contacts, you’ll need frequent checkups and fittings to ensure the lenses fit properly and don’t damage your cornea.
In later stage keratoconus, the cornea can become scarred. This can make glasses or contact lenses ineffective and significantly impact vision. If this occurs, cornea transplant surgery is frequently considered. There are two types of corneal transplant, both using donor tissue. Deep anterior lamellar keratoplasty, or DALK, preserves the inside lining of the cornea, called the endothelium. This surgery can help reduce the potential rejection of this lining that sometimes occurs with a full corneal transplant. Penetrating keratoplasty is a full corneal transplant, which may be required if there is significant thinning or scarring of the cornea.
What Happens If Keratoconus is Not Treated?
It’s important to understand what happens if keratoconus is not treated. Because keratoconus is a progressive eye disease, leaving it untreated can lead to significant corneal scarring, eye pain, and permanent vision loss. As such, it’s vital to seek treatment as soon as you’re diagnosed.
If you’re concerned about the costs of treatment, speak with your insurance provider and ask your eye surgeon about your options. Insurance coverage varies significantly, and the costs for treatment can vary as well. While contact lenses for keratoconus run on the lower end of the spectrum, averaging between $55 to $325 annually, surgical options run much higher. When it comes to keratoconus eye surgery costs, corneal transplant procedures can cost nearly $30,000. The costs for keratoconus treatment can be significant, but it’s important to treat your keratoconus promptly to help prevent progression and preserve your vision as much as possible. If you’re diagnosed with keratoconus, make sure you’re clear on the stage of your disease and what you can do to treat it.
Keep in mind that laser vision correction is not recommended with keratoconus. However, if you don’t have keratoconus, but need vision correction, you might be a good LASIK candidate. Check out our LASIK FAQs and LASIK recovery timeline to learn more about the procedure. Then contact us at Dello Russo Laser Vision today to schedule your free initial consultation with one of our world class eye surgeons. We can help you choose the best options for your eyes and vision needs. We encourage you to explore our LASIK reviews to see why we’ve been the leading eye care providers in the Northeast for over 40 years.
Sources:
https://www.allaboutvision.com/askdoc/keratoconus.htm
https://americanrefractivesurgerycouncil.org/understanding-keratoconus-post-lasik-ectasia/
https://www.allaboutvision.com/conditions/keratoconus-faq/what-is-keratoconus.htm
https://www.mayoclinic.org/diseases-conditions/keratoconus/diagnosis-treatment/drc-20351357
https://www.aao.org/eye-health/diseases/what-is-keratoconus
https://www.researchgate.net/publication/334515744_Wavefront_Analysis_for_Keratoconus
https://www.nature.com/articles/s41598-018-36668-7
https://my.clevelandclinic.org/health/diseases/14415-keratoconus
