Correcting Keratoconus

There’s undeniable beauty in the human eyes. They can express and hide an ocean of emotions, acting as a window to your heart — no wonder they have been the muse of poets for ages. But imagine those beautiful eyes suddenly bulging into a cone shape, like something out of a horror movie. Scary, right? Well, that’s possible, and the condition is called keratoconus, often abbreviated as ‘KC’. To create awareness of the disease, November 10 is observed every year as World Keratoconus Day.

The condition is a progressive eye disease that affects the shape and structure of the cornea, causing vision impairment. Dr Deepti Mehta, a retina specialist, says, “Keratoconus is a condition where the normally round cornea thins and begins to bulge into a cone shape. This irregular shape prevents light from focusing correctly on the retina, leading to symptoms like blurry or distorted vision, increased sensitivity to light, and frequent changes in prescription.”

Although the exact cause of this disease isn’t fully understood, it’s believed to be a mix of genetic, environmental, and behavioural factors.

Dr Bhanu Prakash M, a senior consultant cataract cornea and refractive surgeon, points out that certain groups are more prone to developing keratoconus.

“It commonly begins in the teenage years or early twenties, and in most cases, it progresses slowly over time,” he explains. “Family history plays a significant role; individuals with a close relative who has keratoconus are at a higher risk. It’s also more frequently observed in people with certain systemic conditions like Down Syndrome, connective tissue disorders, and specific allergies,” he explains.

Preventing keratoconus is challenging due to its unclear origins but taking certain steps can reduce risk factors or slow progression, says Dr Prakash.

“Avoiding eye rubbing is crucial because it can weaken the corneal tissue. People with allergies or frequent eye irritation should seek treatment to minimise rubbing. Maintaining overall eye health through regular check-ups is also important, especially for those with a family history of the disorder. Optometrists can detect early signs of keratoconus and suggest management strategies to slow down its advancement.”

Recognising the symptoms

Dr Mehta explains that the symptoms of keratoconus can vary depending on the stage of the condition. In the early stages, people may notice mild blurriness or slight distortions, often mistaking these for regular refractive errors.

As the condition progresses, symptoms may include increasing blurriness or distortion in vision, high sensitivity to bright lights and glare, difficulty in driving at night, and frequent prescription changes for glasses or contact lenses. Since keratoconus symptoms overlap with other vision issues, it can be misdiagnosed, especially in the early stages, making regular eye exams essential for early detection and proper management.

Treatment options

There’s no cure for keratoconus but several treatments can help manage symptoms and slow its progression. The doctors explain that managing keratoconus involves regular monitoring and treatment to maintain vision quality. In mild cases, eyeglasses or specially designed contact lenses, like rigid gas permeable lenses or scleral lenses, can provide a more even refractive surface over the cornea and improve vision. As the condition advances, specialised lenses may be required.

Corneal Cross-Linking (CXL), a minimally invasive outpatient procedure, is often recommended to strengthen the corneal tissue and prevent further thinning. This involves using riboflavin eye drops combined with controlled ultraviolet (UV) light exposure to stabilise the cornea. Intacs, which are small arc-shaped corneal implants, can also help reshape the cornea, improving vision and potentially avoiding a corneal transplant.

In severe cases when the cornea becomes too thin or irregular for other treatments to be effective, a corneal transplant may be necessary. This involves replacing the damaged cornea with a healthy donor cornea.

Early diagnosis and proactive treatment are vital, so if you notice any changes in your vision, make sure to consult an eye specialist right away.

(Written by Vennapusala Ramya)