Keratoconus Eye Treatment in Chicago, IL

What Is Keratoconus?

Keratoconus is a condition that occurs when your cornea, the clear dome-shaped front surface of the eye, thins and gradually begins to bulge outward into a cone shape. This cone-shape causes blurry vision and often light sensitivity. Keratoconus typically affects both eyes, although one eye may be worse than the other. It will generally begin to affect people between the ages of 10 and 25, and is often a slow progressing condition. Keratoconus can be treated with glasses or contacts in the early stages, but as it progresses to an advanced stage, a corneal transplant may be necessary.

What Are The Keratoconus Symptoms And Stages And How Is It Diagnosed?

Patients are often unaware they have keratoconus. The earliest symptom is frequently slightly blurred vision, or progressively decreasing quality of vision that is not easily corrected. 

Other symptoms of keratoconus include:

• Glare and halos around lights
• Difficulty seeing at night
• Irritation and headaches associated with eye pain
• Sensitivity to bright lights
• Sudden worsening or cloudy vision
• Double vision in one or both eyes
• Blurry vision
• Frequent changes in glasses prescription
• Thinning of the cornea

If left untreated, the final stage of the disease is more severe. The vision might worsen considerably, you may become significantly more light sensitive, and the bulging of the cornea may be more noticeable.

In order to diagnose keratoconus, your doctor may perform several tests in addition to a complete eye exam. The doctor may perform one or all of the following:

• Corneal topography: This is the most accurate way to diagnose the early stage of keratoconus. A computerized image is taken that creates a map of the curvature of the cornea.
• Slit-lamp exam: This examination of the cornea can detect abnormalities in the outer and middle layers of the cornea.
• Pachymetry: This test is used to measure the thickness of the cornea, noting the thinnest areas.

Types Of Cornea Thinning Treatment

Keratoconus Glasses

Glasses can be used to treat keratoconus that is in the early stages, and mild. Glasses can correct for myopia and astigmatism, two refractive errors that are common in people with keratoconus. Glasses are only able to correct regular astigmatism, and keratoconus causes irregular astigmatism, which glasses don't correct very well. Because people with keratoconus have high amounts of refractive error, their glasses are often quite thick. In addition, high prescriptions can cause visual distortion. Glasses are a suitable option for those with mild keratoconus, but are often not a good solution for more advanced cases.

Keratoconus Lenses

Soft contact lenses are cosmetically more appealing than glasses but, just like with glasses, are not able to properly correct for the irregular astigmatism of keratoconus. Contacts won't cause the distortion that glasses do, and they are typically very comfortable. However, the vision can still be blurry especially in moderate and severe keratoconus cases.

Gas-permeable contacts are rigid in material, allowing light to refract more evenly through their smooth material, enabling them to correct vision quite effectively. Unfortunately, rigid gas permeable lenses (RGP) can be quite uncomfortable. RGP lenses can offer clear vision while worn, but they do nothing to address the actual condition of keratoconus. 

Sometimes, a patient is fit for both a soft contact lens, and a RGP lens. The soft lens is worn on the cornea, acting as a cushion for the RGP lens, which will sit on top. This is known as a Piggyback contact lens. The piggyback lens can provide better vision and comfort than either of the lenses worn separately, but can often become costly.

Hybrid contact lenses are made of 2 different materials: gas-permeable, and soft. The central portion of the lens is made of an RGP lens to allow for crisp vision, the outer portion of the lens is soft lens material, allowing improved comfort relative to wearing a RGP alone. Hybrid lenses are also costly, and don’t reverse or stabilize keratoconus. 

Scleral contact lenses are made of the same material as corneal RGP lenses, but are much larger in size. Because of their size, they rest on the sclera of the eye rather than the cornea, reducing movement and making them more comfortable. These lenses provide a good balance of visual quality and comfort but can be difficult to insert, remove and handle.

Corneal Crosslinking (CXL)

Corneal Crosslinking (CXL) is a procedure that strengthens the thin and weakened cornea caused by keratoconus. Using Riboflavin (vitamin B) eye drops, in combination with ultraviolet light, the collagen bonds in the cornea are strengthened. While corneal crosslinking wont reverse keratoconus, it does help to stabilize the condition, and hinders further progress. Crosslinking can help to flatten the cornea slightly, potentially improving the quality of vision. Crosslinking is now FDA approved, and is an excellent option for the treatment of keratoconus.

Intacs Corneal Implants

Intacs corneal implants are surgically inserted into the stroma of the cornea. These plastic inserts are strategically placed in the cornea to smooth out the curvature. By altering the shape of the cornea, the quality of vision improves. This procedure can be combined with corneal crosslinking to create stability.

Common Keratoconus Causes And Risk Factors

There are several factors that may increase the risk of developing keratoconus, they include:

• Genetics: Patients with a family history of keratoconus, or with certain systemic disorders, such as down syndrome, are at a higher risk for developing keratoconus.
• Chronic Eye Inflammation: Constant inflammation from allergies or irritants can contribute to the deterioration of the corneal tissue, causing keratoconus to develop.
• Eye Rubbing: Chronic eye rubbing is associated with developing keratoconus. It may also play a part in the progression of the disease. 
• Age: Keratoconus is often diagnosed in the teenage years. Generally, young patients with advanced keratoconus are more likely to need some form of surgical intervention as the disease progresses.

Possible Keratoconus Complications

In some cases, the cornea may swell quickly causing sudden reduced vision and scarring of the cornea. This happens when the inside lining of your cornea breaks down, allowing fluid to enter the cornea, this is known as hydrops. The swelling will usually subside on its own, but a scar may form that affects the vision. Advanced keratoconus may cause the cornea to become scarred, particularly when the cone is most prominent. A scarred cornea causes worsening vision problems and may require a corneal transplant.