What is Keratoconus?

January 2, 2017

Keratoconus is a fairly common condition that can affect the ability to see clearly.  It causes the cornea to be shaped more like a cone than a basketball.  The images above and below from the American Academy of Ophthalmology Website are instructive.  It is often diagnosed when a person is considering LASIK since LASIK should not be performed on someone with this disease.  The eye behaves like a camera, and the cornea helps focus the light onto the film of the camera.  When the cornea is warped and shaped more like a cone, the light is not clearly focused.  This causes blurred vision.  Keratoconus is probably caused by a hereditary predisposition combined with environmental factors that bring it out.  It does tend to run in families, but most first degree relatives (Mothers, Brothers, Fathers, etc) will not be affected in those who have the disease.  There is a continuum of the disease: it starts with blurred vision that can be treated with glasses, and may progress to needing hard contact lenses, and sometimes even surgery to see clearly.  Your eye doctor or ophthalmologist can work with you to get the best vision. The disease tends to manifest during the teenage years and progress through the twenties and thirties.  Most people with the condition will never need surgery.  Rigid gas permeable lenses, hybrid and scleral lenses can usually correct the vision because they form a new "corneal" surface to clear up the focus.  Occasionally the vision can drop overnight and this can be caused by hydrops which is a swelling of the corneal tissue.  In advanced cases, a deep anterior lamellar corneal transplant or a penetrating keratoplasty may be needed.  Sometimes implants called "intacs" can be placed in the cornea to make the cornea more regular and clear up the vision.  Recently, the FDA has approved a procedure called collagen cross linking.  This will often stabilize the cornea and prevent progression.  Now that we have this treatment available, it is more important than ever to be followed for signs of progression if you have keratoconus or forme fruste keratoconus (which is a type of pre-keratoconus).  If you would like to schedule your appointment with Dr. Aaker who is a trained cornea specialist, please call 512-686-1224.

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