World Keratoconus Day 2017

World Keratoconus Day is an opportunity to raise awareness of the disease and is celebrated this year on November 10. Keratoconus is a disease of the cornea that is progressive but not inflammatory. Keratoconus is caused by the weakening of the collagen fibers that would normally maintain the dome shape of the cornea. With this disease, the weakened cornea begins to thin, change its shape and bulge out. This bulging and thinning causes the cornea to take on a gradual cone shape that can severely affect vision.

An initial sign of keratoconus is usually a change in the prescription. Additionally, many patients experience visual disturbances such as glare, halos, and double vision due to the change in shape of the cornea. Over time, patients with keratoconus notice that their vision begins to become distorted and blurry, and because it is a progressive disease, these visual symptoms worsen. Many keratoconus patients tend to be very nearsighted with a high level of astigmatism. Initially, glasses and contact lenses may help with visual changes, but as the disease worsens, glasses and contact lenses lose their useful effects. Opticians tend to refer a patient to an ophthalmologist if these signs begin to occur and worsen, the ophthalmologist will then diagnose the condition and outline a treatment plan.

Keratoconus can occur for many reasons, but the cause is still unknown. The disease can be hereditary and can develop from an early age, so it is recommended that children’s eyes be checked by an ophthalmologist if the disease is hereditary. It can also develop at a later age due to; chronic eye rubbing or laser eye surgery (called ectasia), for example. There are also some other medical conditions where a patient may be more likely to develop keratoconus such as; retinitis pigmentosa, Ehlers-Danlos syndrome, and Down syndrome.

Treatment for keratoconus varies depending on the severity of the disease. As mentioned above, glasses or soft contact lenses are initially recommended to help with visual changes, but as the disease progresses, switching to hard contact lenses or other specialized contact lenses may be beneficial for better vision. These types of contact lenses must fit correctly and follow-up is essential to monitor vision and the condition of the cornea. If glasses and different types of contact lenses don’t work, and as the disease continues to develop, a cornea doctor may recommend a procedure called corneal collagen cross-linking. This procedure, now recommended by the National Institute for Health and Care Excellence (NICE), helps slow or stop the progression of the disease. It works by using ultraviolet light and riboflavin (vitamin B2), to help build and straighten weakened collagen fibers by creating more cross-links between the fibers of the cornea, making it stronger and rougher. Corneal collagen crosslinking can be performed in both children and adults and is rapidly becoming the procedure of choice for ophthalmologists to treat keratoconus due to its safety and efficacy. Other options for treating keratoconus may also include corneal ring implants, which help maintain the natural shape of the cornea, and phototherapeutic keratoplasty (PTK) may also be suggested. If the disease is too advanced and severe, the above treatments may not help, and the only option may be for the patient to undergo a corneal transplant, which can be a partial or full thickness transplant and is only used as a Last resort if other treatments can’t help.

Keratoconus is a serious eye disease and can cause blindness if not properly controlled and treated. There are currently no cures for the disease and the only treatment to help slow or stop keratoconus is corneal collagen crosslinking. It is recommended that patients, adults and children, with keratoconus or suspected keratoconus attend their follow-up appointments and follow the advice of their optician or ophthalmologist.