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KERATOCONUS: CAUSES, SYMPTOMS, COMPLICATIONS & TREATMENT

Eyes have several disorders and Keratoconus is one of them. The eye problem manifests itself by affecting the cornea, which is the superficial part of the eye, making is thin and cause shape irregularities (cone) that make vision difficult.

The normal cornea facilitates proper entry of light into the eye, which is directed to the retina to cause proper vision. When there are shape abnormalities, the light is not properly cast onto the retina which causes eyesight issues.

Keratoconus normally appears in the late teens or early twenties and above, and it can affect one eye or both of them. As the disorder progresses, vision is reduced or may cause double vision and you will also experience light sensitivity.

Keratoconus has for decades affected males and females and studies show that 10% of eye disorders are associated with it. As it worsens, one will find difficulty in;

  • Watching TV
  • Using a computer
  • Using a phone
  • Reading
  • Driving and generally, blurry increases

Sight issues with Keratoconus are due to the tension and strain as a resulting of the enlarged cornea and there will a rapture/fracture/crack. With time, this fracture will heal by itself and a scar tissue will be left behind.

CAUSES OF KERATOCONUS
The actual cause of Keratoconous is unknown, but eye specialists have observed that;

  • Genetics play a huge role as a root for Keratoconus
  • Eye trauma
  • Unattended or untreated eye conditions such as Retinopathy, Retinitis Pigmentosa, and Vernal Keratoconjunctivitis
  • Minor eye issues like scratching for several years due to itching
  • Eye Injuries
  • Prolonged diseases such as Ehlers-Danlos Syndrome, Down Syndrome, Osteogenesis imperfecta, and Leber’s Congenital Amaurosis.

SIGNS AND SYMPTOMS OF KERATOCONUS
Keratoconus signs and symptoms differ from one patient to another but in earlier stages, the disorder presents it’s signs like any other refractive defect in eye patients. General symptoms include;

  • Mild eye irritation
  • Persistent or increased light sensitivity
  • Disturbed vision
  • Blurry
    As the problem progresses, one will experience;
  • Difficulty in wearing contact lenses
  • Glare
  • Increased eye dependence
  • Increment in Blurring and other eye disorders
  • Worsened eye issues like astigmatism and nearsightedness

KERATOCONUS STAGES
Apart from increased sight issues, Keratoconus stages are only known after a diagnostic procedure. The stage of Keratoconus is very vital in treatment and the stages include;

1st Stage

  • This stage comprises of Astigmatism of less or equal to 5.0 D
  • Typical Topography
  • Eccentric steeping induced myopia
  • K- reading of less than 48.00 D

2nd Stage

  • It comprises of
  • K-reading of less or equal to 53.00
  • Pachymetry of greater or equal to 400um
  • Eccentric steeping induced myopia or Astigmatism of 6.00 or 7.00 D

3rd Stage

  • It comprises of;
  • K- reading greater than 53.00 D
  • Eccentric steeping induced myopia or Astigmatism from 8.01 D to 10.00 D
  • Pachymetry of 200 D to 400um

4th Stage

  • Scar tissue
  • K- reading greater than 55.00 D
  • Pachymetry greater or less than 200um
  • Unmeasurable Refraction

COMPLICATIONS
Earlier stages may be mistaken with common eye disorders and there are no complications except in the last stages of Keratoconus.
After the formation of the scar, one will require advanced treatment procedures and mere contact lenses or eye drops may provide no help.

The enlarged cornea will will automatically make one’s life difficult and you have to schedule an appointment with an eye care practitioner or an Ophthalmologist

DIAGNOSIS OF KERATOCONUS
The following are performed

  • Through routine checkups, the Ophthalmologist is able to diagnose Keratoconous
  • Physical examination of the eyes
  • Eye Charts
  • Thew medical history of the patient
  • Diagnostic procedures are conducted to detect astigmatism, and nearsightedness
  • Retinoscopy
  • Corneal Topography

The shape of the cornea can also be determined through;

  • Computerized mapping
  • Keratometry

KERATOCONUS TREATMENT
There are various options for keratoconus treatment in India, but each depends on the stage or the severity of Keratoconus. It should be noted that minor keratoconus can be treated with specialized eye drops or eyeglasses. Where the disease has spread, the following are the possible treatments;

1. CORNEAL CROSSLINKING
Also known as Corneal Collagen Cross-Linking, the procedure is divided into two types, i.e Epithelium on and Epithelium off
The Epithelium-on Procedure
This procedure doesn’t alter the corneal epithelium but requires a longer period of treatment for the riboflavin to thorough sink into the cornea.
The Epithelium-off Procedure
With this procedure, the outer lining of the cornea called the epithelium, is cut off to allow riboflavin to penetrate into the cornea.

Epithelial debridement is normally used to treat hereditary eye irregularities

2 SPECIALISED CONTACT LENSES
Customized soft contact lenses are normally recommended to correct minor to moderate Keratoconus eye cases. The contact lenses are designed according to one’s eyes

3 OTHER LENSES
These include Hybrid contact lenses, Gas permeable contact lenses, Scleral and semi-scleral lenses and Piggybacking contact lenses.
Hybrid Lenses
Hybrid lenses have been widely used to treat Keratoconus and they have produced much comfort to the patients. This is the main advantage of hybrid lenses over gas permeable lenses
Gas permeable contact lenses
These lenses allow more oxygen to penetrate to the cornea something which other lenses hardly do. In addition, the GP lenses can be brought nearer to the surface of the eye.
Scleral and semi-scleral lenses
Scleral lenses are large enough to cover the entire scleral of the eye, whereas the semi-scleral will cover a portion. Any of the scleral lenses can be used as the eye care practitioner may observe. The lenses can also be used to treat progressive or severe dry eyes
Piggybacking contact lenses (two in one)
These lenses increase comfort that the gas permeable lenses since they are cone-shaped. The two lenses are fitted in a way that oxygen will effectively penetrate through to the eye and one will be closely monitored by the Optometrist for a couple of sessions

4 INTACTS
Intacts are an option for many patients who haven’t been helped through contact lenses. They are approved by FDA and are widely used by patients. Intacts are surgically placed beneath the eye’s surface in the periphery of the cornea to reshape the cornea. The main aim is achieving a better vision.
Intacts have an advantage of being removed if necessary

5 CORNEAL TRANSPLANT
A corneal transplant is the last resort for many Keratoconus patients who may attain no effective vision from other treatment procedures. The surgery is performed, but one may meet certain risks and rejection. The procedure requires much advanced skills and technology

Another possible treatment procedure is the Conductive Keratoplasty with the guidance of Topography. These highly advanced treatment procedures, may raise the Keratoconus treatment cost in India and will require excellent diagnosis and proper treatment approaches.

Keratoconus Treatment AT Rana Hospital

If you are looking for Keratoconus Treatment, Dr. Brijinder Singh Rana at Rana Hospital offer best value vitreoretinal surgery in Punjab. The range of ophthalmology services included at Rana Hospital but are not limited to pediatric eye care, LASIK correction, cataract, diabetic retinopathy treatment, vitreoretinal surgery, restorative surgery, and other ancillary eye services.

Find out more about viteroretinal eye surgery and other procedures by contacting us at: +91-9815709777.

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