Have you ever thought that what would happen if your eyes get into trouble one day? The truth is a series of eye-related diseases progress so slowly and silently that it would be too late while noticing it.
One of these diseases, which we notify very late, is keratoconus. When I first saw the name, it was so strange to me that I thought it might be the name of a planet! Have you ever heard about this disease? If you are one of those people who have not even heard of this word and wondered while hearing it, I suggest you to read this article until the very end of it.
Keratoconus (Conical Cornea) Is Exactly What Its Name Suggests
The fact is that in this disease, the cornea deforms and changes to a cone shape. This deformation affects the amount of light entering the eye. Unfortunately, in 90% of the cases, both eyes are affected. Sadly, we do not go to an ophthalmologist until our eyesight gets disturbed. To be honest, I’m also a part of this group of people.
The first time when I heard the name, I told myself: “Is it really possible that the cornea of the human eye become conical in shape?” or “Is it possible to have a cone-shaped cornea and do not notice it?”
It was a strange thing and that was enough for me to start my studies on the matter. After research, I found that the disease of the cornea was exactly what its name had implied. In fact, the cornea of the eye becomes progressively thinner and deforms into a conical-shape. This deformation affects the amount of light input on the eye.
What Are the Symptoms of Keratoconus?
As previously mentioned, most of us do not visit an ophthalmologist until our vision is disturbed. I’m also like you. I visit an ophthalmologist once a year just to check my eyesight number. Every time I do so, I feel I have nothing else but a pair of weakened eye. Well, health disregard usually brings bad results, and in this case, this bad result is keratoconus.
You may also have blurry vision, aura and light sensivity. A person with conical cornea may also suffer from nearsightedness (also known as shortsightedness or high myopia) and astigmatism. In general, it is not easy to diagnose this disease and you should see your doctor. At a stage in which the disease progresses, there are signs that everyone in such a condition will notice a change and disorder in their eyes. These signs are:
- Sudden Change of Vision in the Eye
- Double Vision
- Inability to Drive at Night
- Blurred Vision
- Sensitivity to Light
- Continuous Change of Eyeglass Prescription
What Is the Cause of Corneal Thinning?
I think you posed a very important question. Researchers have discovered a direct relationship among continuous and vigorous eye rubbings and long-term use of contact lenses with the occurrence of this disease. However, these are not the main causes of this disease; they only exacerbate it. Family history of this disease, the environment and some other diseases can also affect the progress of keratoconus.
However, the main cause source of this disease is the weakness of the collagen protein in the cornea. This deficiency causes the structural and biomechanical weakness of the cornea and creates a conical shape with irregular astigmatism. The progression rate of the disease varies from person to person, sometimes the disease never progresses in one person and sometimes it progresses rapidly in another one. Another point about conical cornea is that the disease is more common in people with Down syndrome and Marfan syndrome than in healthy ones.
Corneal keratoconus is also more common in the countries, which have a warm, cold and dry weather, than other ones. The reason is that such a climate is more allergenic.
Please Visit an Ophthalmologist!
Given that the disease progresses over time, early diagnosis can totally prevent its progression. To diagnose, you should first consult an ophthalmologist. The ophthalmologist examines the cornea with corneal imaging, the use of various topographic techniques, as well as family history to diagnose KC. Control your stresses and worries if you had this disease. Although we do not have much information about keratoconus and hearing its name may confuse us, medical and ophthalmology specialists and researchers are investigating this disease every year and discovering new methods of controlling and curing it. The tests used to cure keratoconus are as follows:
Eye Reflection Test
In this test, the ophthalmologist uses special equipment to examine your eyes thoroughly. He may not use a device that contains various lenses or hand tools (retinoscopes) to assess the eye.
The ophthalmologist directs a vertical light beam to the eye surface and uses a low-power microscope to check the shape of the cornea.
In this method, the ophthalmologist similarly uses light to test the cornea. In fact, the ophthalmologist focuses a light circle on the cornea to check its movement and response.
In this method, using special photographic tests, such as combined optical tomography and corneal topography, the ophthalmologist captures accurate images of the cornea and then, examines them.
What Should I do to treat this Damn (!) Conical Cornea?
No worries about this! Just go along with me to explore different ways of keratoconus treatment. Generally, to treat conical cornea, the physician prescribes one of the aforementioned treatments by examining the progression of the disease in various stages.
Step One: You should wear Eyeglasses
In the early stages of the disease, it has not much progressed. Therefore, the ophthalmologist will try to improve your eyesight by prescribing glasses. Consider the fact that the disease is progressive and the eye-sight number will change constantly.
Step Two: Using Hard Contact Lenses
In the second step, the disease has progressed more than before and nearsightedness and irregular astigmatism would possibly appear. In this condition, the disease is not controllable with eyeglass prescription. The doctor prescribes hard contact lenses to improve vision at this stage. When the ophthalmologist places these lenses on the cornea, the lacrimal layer formed between the lens and the cornea corrects the irregularities. Of course, there are some people cannot tolerate wearing these lenses and in this case, the doctor prescribes hybrid lenses (combination of hard and soft lenses).
Step Three: Keratoconus Surgery
In the third step, the disease has so much progressed that the ophthalmologist uses surgery for treatment. Surgery is done to plant a ring inside the cornea. When the patient cannot tolerate hard lenses, this type of surgery is also performed for weak or mild cases. In this operation, the surgeon corrects much of the irregularities created at the corneal surface and the patient will have a much better eyesight (sometimes using new eyeglasses).
Step Four: Corneal Cross-linking Surgery
When keratoconus has progressed very much, performing corneal cross-linking surgery is the best way to treat and stop the progression of the disease. This treatment, using a series of chemical changes, strengthens the corneal tissue, enhances the corneal strength, and thus greatly reduces the progression rate of the disease. In fact, in this method, after removing the cornea cells layer for thirty minutes (every three minutes), a 1% drop of riboflavin is poured into the eye every five minutes. After thirty minutes, the ultraviolet radiation is directed to the cornea. This, as mentioned before, strengthens the cornea. Approximately, in 100% of the cases, the progression of the disease is controlled and in half of the cases, the cornea becomes slightly flattened i.e. the disease improves.
Step Five: Corneal Transplantation
The last resort is to use corneal transplantation in cases where the disease has progressed significantly or none of the above treatments has helped to improve the patient’s vision. Generally, progressed and uncorrected KCN is one of the most important reasons for corneal transplantation; a surgery that is generally successful.
LASIK and LASEK Eye Surgery Are Not Suitable For the Treatment of Conical Cornea
I whisper in your ears once again that do not use LASIK and LASEK eye surgery to treat keratoconus. LASIK and LASEK are not used to treat keratoconus. In principle, the ophthalmologist photographs the cornea prior to the LASIK and LASEK surgery to make sure of the disease presence. In fact, if the cornea is thin or cone shaped, the patient will not be able to undergo LASIK or LASEK surgeries.
LASIK and LASEK are among the most commonly used eye surgeries. These two operations, which are considered as laser surgeries, are almost lexically similar, but the surgical process is completely different. LASIK surgery is used to treat nearsightedness and other refractive errors, and the LASEK is used to treat severe nearsightedness or those patients who face medical restrictions.
Nevertheless, Why Is LASIK and LASEK Not Useful for Keratoconus Treatment?
The answer is here! In keratoconus, the cornea becomes thinner and deforms into a conical shape. In fact, the corneal tissue strength decreases and makes irregularities in the tissue. If someone undergo LASIK or LASEK under these conditions, the irregularities of the corneal tissue is accelerated and even the patient’s blurred vision becomes aggravated. That is, by performing these surgeries, corneal tissue condition does not improve and the process of disorder in the corneal tissue is accelerated, as well. These are the same reasons why LASIK and LASEK are not used for treating conical cornea.
The Final Word
With the early diagnosis of conical cornea, you can completely prevent it and enjoy having healthier eyes. However, if the physician diagnosed the presence of keratoconus disease, you should care about treating it and trust your doctor in that. He/she will choose one of the treatment methods and stop the disease progress. Choosing any of the treatment methods in each of the disease stages or combining them depends on the ophthalmologist’s diagnosis and patient’s condition.
If you have some experiences about conical cornea, please share with us.