What is keratoconus?

Keratoconus (from Greek: kerato- horn, cornea; and konos cone), is a degenerative disorder of the eye in which structural changes within the cornea cause it to thin and change to a more conical shape than its normal gradual curve.

New research suggests the weakening of the corneal tissue that leads to keratoconus may be due to an imbalance of enzymes within the cornea. This imbalance makes the cornea more susceptible to oxidative damage from compounds called free radicals, causing it to weaken and bulge forward. Risk factors for oxidative damage and weakening of the cornea include a genetic predisposition, explaining why keratoconus often affects more than one member of the same family. The exact cause of keratoconus is uncertain, but has been associated with detrimental enzyme activity within the cornea. A genetic link seems likely, as the incidence rate is greater if a family member has been diagnosed.

Keratoconus also is associated with overexposure to ultraviolet rays from the sun, excessive eye rubbing, a history of poorly fitted contact lenses and chronic eye irritation from allergies. Other research suggests a hormonal link may exist.

Keratoconus can cause severe distortion of vision, with multiple images (ghosting), streaking and sensitivity to light (halos). It is often diagnosed in the patient’s teenage years and gets worse in the twenties and thirties. As keratoconus is bilateral in 95% of cases, afflicting both eyes, the deterioration in vision can affect the patient’s ability to drive or read normal print, operate machinery, computers and so on. In most cases, corrective contact lenses are effective enough to allow the patient to continue to drive legally and likewise function normally, which includes continuing to work, play sports and live a normal life.

Further progression of the disease may require surgery including intrastromal corneal ring segments (Intacs, ferrara rings), corneal collagen cross-linking (CXL, C3R) or corneal transplantation/ corneal graft. However, despite the disease’s unpredictable course, keratoconus can often be successfully managed with little or no impairment to the patient’s quality of life.
Keratoconus affects around one person in two thousand, and 1 in 500 of the black and Asian communities, people with Down’s Syndrome often have keratoconus.

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27 thoughts on “What is keratoconus?

  1. […] I dropped him at the test centre, thought nothing of it, other than I would pick him up in couple and then my real teenage boy worries would start. Bang! He failed the test….he couldn’t see well enough to read a number plate. I took him straight to opticians after all it must be something simple…but it is his sixteenth birthday and the optician is telling us he has something called ‘keratoconus’ !? […]

  2. […] Eight weeks on & I’m fully healed however unfortunately my vision is like a whiteout I’m really bothered with light sensitivity & can see shapes etc…. but that’s it. I had my eye test done by hand & could barely see the nurses fingers. I’m seen by my consultant & he tells me I’m left with no option other than having a full thickness penetrating keratoplasty. I’m in shock but also pleased at the same time. I’m put on the waiting list that day & I wait 8 weeks to have the operation itself. For details about my operation experience you can read this is past blogs on the Keratoconus GB WordPress page. […]

  3. […] Collagen crosslinking involves removal of the surface corneal epithelial cell layer, saturation of the cornea with 0.1 % riboflavin for 30 minutes (1 drop is applied every 2 minutes) followed by application of UV light for 30 minutes. The corneal thickness needs to be over 400 microns for the procedure to be safe and effective.  Collagen Cross-linking has been used for many years in the field of Dentistry. Corneal Collagen Cross-Linking with Riboflavin was first used in 1998 to treat Keratoconus. […]

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