Eye Care Services

Understanding Keratoconus
Perhaps the most difficult thing about keratoconus is just how little many people afflicted with the eyesight condition understand about it. It’s a progressive, slow-developing degenerative disorder, which means that those suffering from it may not even realize what the problem is until it has significantly advanced.

In other words, eyeglass prescription after eyeglass prescription, blurry day after blurry day, their vision just keeps getting worse.

But with proper diagnosis and understanding, keratoconus is a treatable disorder that can be managed without significant interruption to one’s life.  
So to better understand keratoconus, here are some basic facts about it:

How does it work?
Imagine seeing the world through a poorly made magnifying glass—that’s keratoconus. Basically, the cornea—the clear, round “window” of the outer eye responsible for controlling incoming light—begins to bulge and eventually warp into a cone shape. This alters the way light enters the eye before reaching the retina—the light-sensitive tissue in the inner eye that acts as the “film in the camera”—ultimately distorting vision.

It’s progressive, which mean it gets worse and worse over time before eventually stabilizing.

What are some symptoms?
The irregular reshaping of the cornea can cause two primary conditions: progressive nearsightedness and irregular astigmatism, resulting in blurry, distorted vision, and more minor problems like light sensitivity and glare.
In daily life, this means difficulty reading, driving, focusing on small objects, or even watching TV or bright movies. Also, without understanding the progressive nature of keratoconus, patients with eyeglasses for nearsightedness and astigmatism might find themselves needing to continually (and expensively) change prescription again and again over time.

Who is at risk?
It’s not exactly common—estimates usually place the affection rate at one-in-2,000, but keratoconus can develop in anyone. It happens to both males and females all over the world, and it can happen either in one or both eyes. Most often, however, you’ll begin to see keratoconus develop during a patient’s mid-teens or early 20s.

How can it be treated?
For the mildest cases, corrective eyeglasses or soft contact lenses will usually do the trick. But because keratoconus usually (but not always) develops so slowly over time, many affected patients don’t even realize their vision is eroding until it’s too late for simple fixes, and more extensive treatments for more advanced cases are often needed.

Unlike soft contact lenses, rigid gas permeable (RGP) contact lenses can replace a keratoconic cornea’s irregular shape with a smooth, effective lens that will properly refract light and ultimately improve vision.  Since putting in an RGP contact lens can be difficult, time-consuming, or uncomfortable, some people choose to “piggyback” lenses—placing an RGP lens over a soft lens. The softer lens essentially pads the eye against the more irritating RGP lens.

Intacs—intrastromal corneal ring segments inserted into the eye through a minimally invasive surgical procedure—can also be used to better fit lenses over a cone-shaped cornea. If lenses still don’t work,  a new treatment under development called corneal crosslinking could succeed in halting keratoconus progression. Corneal transplants are sometimes considerd in severe cases.

Dr Karanges and Dr Nguyen are considered experts in contact lens fitting for keratoconus. We have fit hundreds of patients successfully and can achieve excellent visual acuity with custom fit gas permeable and soft contact lenses .  We receive referrals from area doctors for treatment of patients with this condition.