What is keratoconus, and what's it like living with it?

In this article below, highly experienced consultant ophthalmologist, Miss Zahra Ashena, details what keratoconus is, and what it’s like for patients living with the eye condition.

What is keratoconus?

Keratoconus is a progressive eye condition that affects the cornea, the clear, dome-shaped front surface of the eye. In keratoconus, the cornea thins and bulges outward into a cone shape, distorting vision. This condition typically begins in adolescence or early adulthood and can progress for 10 to 20 years before stabilizing.

What are the main causes and risk factors?

The exact cause of keratoconus is unknown, but it is believed to be a combination of genetic and environmental factors. A family history of keratoconus increases the likelihood of developing the condition. Environmental factors, such as excessive eye rubbing, chronic eye irritation, and poorly fitting contact lenses, can also contribute to its progression. Additionally, certain systemic conditions like Down syndrome and connective tissue disorders are associated with a higher incidence of keratoconus.

What are the symptoms of keratoconus?

Keratoconus symptoms often start with a slight blurring of vision and increased sensitivity to light. As the condition progresses, symptoms may include distorted or double vision, ghosting, and frequent changes in eyeglass prescriptions.

The irregular shape of the cornea causes irregular astigmatism and myopia, which can make vision correction with glasses challenging. Advanced keratoconus can lead to significant vision impairment, affecting daily activities like reading, driving, and recognising faces.

How is keratoconus diagnosed and treated?

Diagnosing keratoconus involves a comprehensive eye examination. Ophthalmologists use several diagnostic tools, including corneal topography, which maps the surface curvature of the cornea, and pachymetry, which measures corneal thickness. These tests help detect the characteristic cone-shaped bulging and thinning of the cornea associated with keratoconus.

Treatment for keratoconus depends on the severity of the condition. In the early stages, vision can often be corrected with eyeglasses or soft contact lenses. As keratoconus progresses, rigid gas permeable (RGP) contact lenses or scleral lenses, which vault over the cornea and rest on the white part of the eye, may be necessary to improve vision.

Corneal collagen cross-linking (CXL) is a minimally invasive procedure that can halt the progression of keratoconus. This treatment strengthens the corneal tissue by using ultraviolet light and riboflavin (vitamin B2) to form new cross-links between collagen fibres.

In advanced cases, when contact lenses or cross-linking are no longer effective, a corneal transplant (keratoplasty) may be required. During this procedure, the damaged cornea is replaced with a healthy donor cornea, restoring vision.

What is it like living with keratoconus?

Living with keratoconus requires regular eye check-ups to monitor the condition's progression and adjust treatment as needed. Early diagnosis and appropriate management are crucial for preserving vision and maintaining a good quality of life. By staying informed and proactive in their eye care, individuals with keratoconus can effectively manage their condition and lead active, fulfilling lives.

To book an appointment with Miss Zahra Ashena today, visit her Top Doctors profile.