What is Keratoconus?

09 April 2019

Author: Kate Green

What is keratoconus and corneal cross linking

Understanding Keratoconus

 

Keratoconus is an eye disorder which affects around 1 in 2,000 people. A person’s cornea, the transparent front part of the eye, gradually becomes thinner, weaker, and begins to bulge forwards in a conical shape. This can lead to blurry vision, short-sightedness, astigmatism and light sensitivity. Mostly diagnosed in the patient’s late teens or early twenties, it is a condition which gets progressively worse until their late 30s, when it begins to stabilise. The causes of Keratoconus are unknown but the process is suspected to come as a result of a combination of environmental, genetic and hormonal contributors. Environmental factors can be vigorous rubbing of the eyes due to allergies which cause a reaction in the eyes.

 

In terms of genetic factors, it has been observed that between 6-19% of Keratoconus patients have family members also affected by the disease. Further to this, studies looking into Keratoconus in identical twins have shown that if one twin develops it, the other twin is also likely to. It is clear that more research is needed into the patterns and causes of Keratoconus, hopefully bringing preventative measures to improve the lives of thousands.

 

Early Keratoconus usually begins with mildly blurred vision but can rapidly deteriorate to the point that the patient may begin seeing multiple images, instead of just one point. These multiple images can make it harder to focus on a single point. Night vision can also be severely impaired. Keratoconus doesn’t cause blindness but can impair vision profoundly through thinning of the cornea and further corneal scarring. This stops the cornea from being entirely transparent and also doesn’t allow the eye to focus properly.

 

In the early stages of Keratoconus, the patient can wear regular contact lenses to correct their vision but later, as the cornea thins, they will need to invest in rigid gas permeable (RGP) contacts. Another option for advanced Keratoconus is a corneal transplant which is quite an invasive procedure. However, over the last few years, a new treatment called Corneal Cross-Linking (CXL) has been made available. This means that there is now an alternative, less invasive procedure available for Keratoconic patients.

 

What is Corneal-Cross Linking?

 

Often referred to as CXL, corneal-cross linking prevents the advancement of Keratoconus, meaning that it is particularly ideal for patients who have been diagnosed early on in the process. It is only suitable for when a patient has progressive Keratoconus where the condition is active and worsening. It can’t repair any previous corneal damage. However, if the cornea is too thin, the procedure becomes too risky and it may just be safer to leave the cornea to become more rigid with age.

 

The CXL treatment uses a combination of vitamin B drops and UV light to react with the natural collagen fibres in the cornea. This reaction strengthens the fibres and mimics the natural cross-linking process that happens as a person ages. The treatment successfully stops the progression of Keratoconus in 94% of patients who undergo the procedure. Further to this, 45% of patients also benefit from an improved corneal shape as a result of CXL with the cornea becoming less conical. As well as halting the progress of Keratoconus, 50% of patients also benefit from visual improvement from CXL, although nearly everyone will still need to wear glasses or contacts following treatment.

 

If you suffer from Keratoconus and feel that you would benefit from corneal cross-linking to prevent your vision from becoming worse, get in touch with us or request a free information pack. Our consultants will be able to assess you and determine which treatment path is most suitable for you.


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