World Keratoconus Day is recognised on Tuesday, November 10th, 2020. Keratoconus is a condition where the normally rounded shape of the cornea (transparent layer forming the front of the eye) assumes a conical shape because of thinning and protrusion. Typically, an affected patient in their teens or twenties seeks consultation for symptoms of light sensitivity, progressive vision blurring and/or distortion. It is usually present in both eyes, although one may be more affected than the other.
The onset of keratoconus usually occurs at the age of puberty and can continue to worsen over 20 years until progression gradually stops. The prevalence is about 1 in 4000 and can affect all ethnic groups. Eye-rubbing has been implicated as an important causative factor in the development of keratoconus. Allergic eye disease causes itchy and irritated eyes which leads to eye rubbing. Genetic and hereditary factors can also contribute to the development of keratoconus.
Corneal imaging is now indispensable in diagnosing keratoconus. Valuable information, such as cornea power, thickness and elevation, will help in diagnosing the mildest form of keratoconus.
In mild keratoconus, vision can be improved with spectacles or certain types of contact lenses, but progression of the disease is not halted. Corneal Cross-linking (CXL)is a minor surgical procedure that may slow or halt progression of keratoconus. Topical Riboflavin (Vitamin B2) is applied to the cornea for approximately 30 minutes followed by ultraviolet light. This process produces chemical reactions that strengthen and stiffen the cornea thereby increasing the rigidity. Some patients also gain improvement in vision with CXL.
In severe Keratoconus, the patient’s vision is so severely impaired that more invasive surgery, such as cornea transplant, is needed. The diseased cornea is surgically removed and replaced with a suitable donor cornea received from an eye bank.
Once diagnosed with keratoconus, please consult an Ophthalmologist with suitable training in cornea diseases, for counselling and treatment options.