Procedures
What You Need to Know. Keratoconus is an eye disease that affects the structure of the cornea, resulting in loss of vision. Keratoconus occurs in approximately one in 2,000 individuals, typically beginning in puberty and progressing into the mid-30s. Early stages can be treated with glasses, but with progression of the disease into late childhood and early adulthood, corneal transplantation may be needed to restore sight.
What is keratoconus and how is it treated?
Some studies on glaucoma and marijuana have found that when marijuana is smoked or when a form of its active ingredient is taken as a pill or by injection, it does lower pressure in the eye, or intraocular pressure. However, it only lowers the pressure for a short period of time—about three or four hours.
Does weed help for keratoconus?
There are several methods for treating keratoconus, depending on how severe the condition is. In the early stages of the disease, vision can be corrected with normal eyeglasses or soft contact lenses.
Can keratoconus be corrected?
Substances
- Anti-Infective Agents
- Delayed-Action Preparations
- Nitric Oxide
Are there alternative treatments for keratitis?
Which treatment is best for keratoconus?
Cornea transplant for keratoconus generally is very successful, but possible complications include graft rejection, poor vision, infection and astigmatism. Astigmatism is often managed by wearing hard contact lenses again, which is usually more comfortable after a cornea transplant.
Is there any new treatment for keratoconus?
Corneal Collagen Cross-linking (CXL) The minimally-invasive, advanced therapy slows down or stops the progression of the corneal deformation of keratoconus, by making collagen bonds in the cornea stronger, allowing it to become stiffer and usually stop bulging out.
How do you stop keratoconus from progressing?
Early stages can be treated with glasses, but with progression of the disease into late childhood and early adulthood, corneal transplantation may be needed to restore sight. Corneal collagen cross-linking is a procedure designed to stop the progression of keratoconus or slow it down.
Can severe keratoconus be corrected?
There is no cure for keratoconus, but you can manage it effectively with treatment. The most effective treatment for this condition depends on its severity. There are several treatments available to help effectively manage keratoconus.
Can keratoconus be cured without surgery?
There are many Keratoconus doctors, especially here in the Los Angeles area, who want to get you onto their operating table as quickly as possible for a corneal surgery of one type or another, but what we find is that most patients can be treated non-surgically and enjoy a happy, normal life.
What can worsen keratoconus?
Irritation and inflammation from allergies, asthma and other atopic eye diseases can lend to the development of keratoconus. Frequent eye rubbing. Intense and frequent eye rubbing is thought to thin out the cornea and can worsen the condition.
How do you slow down keratoconus?
You may be able to reduce your chance of getting keratoconus by:Protecting your eyes from UV radiation with sunglasses.Making sure your contact lenses fit well.Getting treatment for any kind of eye discomfort (for example, from allergies)Not rubbing your eyes.
Can I live a normal life with keratoconus?
The good news is that it does not have to be this way and that patients with keratoconus can go on to live normal lives just like any other person with good sight. You just need the proper treatment in order to get good vision back.
Can vitamins help keratoconus?
The combination of riboflavin (vitamin B2) drops and ultraviolet A light applied to the eyes can make a positive impact on the vision of patients who have bulging corneas (keratoconus).
Can you go blind from keratoconus?
Can You Go Blind from Keratoconus? Although keratoconus can progress rapidly in the beginning, it rarely causes blindness. Most people develop this condition during puberty. First, there may only be myopia and astigmatism, but this can rapidly evolve into severely reduced and distorted vision.
Do sunglasses help keratoconus?
For the vast majority with keratoconus, eyeglasses are the “wrong medicine” to restore optimal vision. Nothing is as effective as special rigid surface contact lenses — not even corneal cross-linking or Intacs surgery — for bringing out maximal vision for keratoconus.
How to treat keratoconus?
Generally, there are two approaches to treating keratoconus: slowing the progression of the disease and improving your vision.
How to diagnose keratoconus?
To diagnose keratoconus, your eye doctor (ophthalmologist or optometrist) will review your medical and family history and conduct an eye exam. He or she may conduct other tests to determine more details regarding the shape of your cornea. Tests to diagnose keratoconus include: Eye refraction. In this test your eye doctor uses special equipment ...
What is the procedure called when the cornea is saturated with riboflavin?
Therapies. Corneal collagen cross-linking. In this procedure, the cornea is saturated with riboflavin eyedrops and treated with ultraviolet light. This causes cross-linking of the cornea, which stiffens the cornea to prevent further shape changes.
What is the procedure to remove scarring from the cornea?
Penetrating keratoplasty. If you have corneal scarring or extreme thinning, you'll likely need a cornea transplant (keratoplasty). Penetrating keratoplasty is a full-cornea transplant. In this procedure, doctors remove a full-thickness portion of your central cornea and replace it with donor tissue.
What is the best test to detect keratoconus?
Special photographic tests, such as corneal tomography and corneal topography, record images to create a detailed shape map of your cornea. Corneal tomography can also measure the thickness of your cornea. Corneal tomography can often detect early signs of keratoconus before the disease is visible by slit-lamp examination.
What is the best way to evaluate your eyes?
Some doctors may use a hand-held instrument (retinoscope) to evaluate your eyes. Slit-lamp examination. In this test your doctor directs a vertical beam of light on the surface of your eye and uses a low-powered microscope to view your eye. He or she evaluates the shape of your cornea and looks for other potential problems in your eye.
What type of contact lens is best for keratoconus?
Hard contact lenses. Hard (rigid, gas permeable) contact lenses are often the next step in treating more-advanced keratoconus. Hard lenses may feel uncomfortable at first, but many people adjust to wearing them and they can provide excellent vision. This type of lens can be made to fit your corneas. Piggyback lenses.
Best Keratoconus Treatments and Commonly Accepted Clinical Practices
At this time, Scleral Contact Lenses and Corneal Cross-Linking (CXL) are, without question, considered among the best keratoconus treatments. These treatments won’t benefit every patient; however, it’s highly your keratoconus specialist will discuss their use.
About Dr. Richard Driscoll
Dr. Driscoll is a therapeutic optometrist and keratoconus specialist at Total Eye Care in Colleyville, Texas. A 1988 Graduate of the Illinois College, Dr. Driscoll has been treating patients with keratoconus for over 30 years. Following Dr.
What is the treatment for keratoconus?
Corneal Collagen Crosslinking with Riboflavin keratoconus treatment, sometimes referred to as C3R, involves bathing the cornea with a solution of riboflavin, then exposing the cornea to UV light after the riboflavin has sufficiently penetrated the cornea. Cross linking is one of the newest surgical keratoconus treatments. Cross linking for keratoconus was approved by the FDA in 2016. The UV light activated riboflavin greatly increases the connections between the collagen fibers (cross linking). The increased connections between the collagen fibers increases the strength of the cornea. This increased strength tends to stabilize the cornea, often stopping further corneal steepening.
How long does it take to get soft keratoconus lenses?
The disadvantage of soft keratoconus lenses is high cost, poor vision for most patients, and limited manufacturers. It usually takes 3 to 4 weeks to accept delivery of these types of lenses. There are much better options available with better comfort and visual acuity.
What is C3R treatment?
Corneal Collagen Crosslinking with Riboflavin keratoconus treatment, sometimes referred to as C3R, involves bathing the cornea with a solution of riboflavin, then exposing the cornea to UV light after the riboflavin has sufficiently penetrated the cornea.
Why do corneal transplants cause keratoconus?
The most common reasons where corneal transplants are used in keratoconus treatment are; Severe scarring or distortion results in unacceptable visual acuity even after keratoconus treatment with scleral or gas permeable contact lenses. Frequent episodes of corneal hydrops.
Why are scleral contacts so comfortable?
Many people look at a scleral contact lens and assume because the lens is large it must be uncomfortable. Fortunately, for tens of thousands of keratoconus patients wearing scleral contacts, nothing could be further from the truth. A larger lens provides greater comfort. Better vision is also achieved with a larger lens. A scleral lens rests on the white part of the eye, which is called the sclera, and vaults over the cornea without touching it. Since scleral contacts place virtually all of their weight on the sclera they avoid the highly innervated cornea, which also greatly improves comfort.
What are the advantages and disadvantages of hybrid contact lenses?
The advantage of hybrid lenses is their high availability, having a large network of doctors fitting them. High cost, sometimes less than optimal vision, and poor durability are the biggest disadvantages to hybrid lenses. While the soft skirt improves the comfort of a gas permeable lens it also presents a weak point. The junction where the soft skirt is bonded to the gas permeable lens is a weak point and often separates. At Total Eye Care, our keratoconus specialists find patients report better vision and consistently better comfort with scleral contact lenses.
Is keratoconus progression best evaluated with corneal topography?
Keratoconic progression is best evaluated with corneal topography readings taken and evaluated over time. If the cornea is stable then it is usually best to stay with more conservative keratoconus treatment options since there is nothing to be gained with cross linking yet the potential surgical risks remain.
Eyeglasses or Soft Contact Lenses
Wearing prescription lenses improves your vision because the lenses bend rays of light to focus images on the retina inside your eye. The cornea is the clear dome-shaped part of the front of the eye and is responsible for the majority of the focusing of the eye on the retina.
Specialty Contact Lenses (RGP, Scleral, Hybrid)
Rigid gas permeable (RGP) contact lenses and specialty scleral contact lenses create a smooth, uniform surface, allowing the light to be clearly focused. A saline solution fills in the space between the rigid lens and the cornea, “masking” the irregular corneal shape.
Corneal Cross-Linking (CXL)
This minimally invasive procedure uses Riboflavin eye drops plus UVA light to slow keratoconus progression. Riboflavin eye drops are activated with UVA light to create additional cross-link bonds in the cornea, making it stiffer. CXL does not restore vision that has already been lost and does not eliminate the need for glasses or contact lenses.
Intracorneal Ring Segments (ICRS)
These specifically designed implants are made of medical plastic that are surgically placed under the surface of the cornea to help improve the corneal shape. The ICRS are implanted into the cornea to flatten the steep part of the cone into a more regular shape.
Corneal Transplant Surgery
This surgery replaces part of the cornea with donor tissue to improve corneal shape and/or clarity. The irregular or scarred corneal tissue is replaced with donor tissue from a cornea without keratoconus.
What is the best treatment for keratoconus?
10. Corneal transplant . Some people with keratoconus can't tolerate a rigid contact lens, or they reach the point where contact lenses or other therapies no longer provide acceptable vision. The last remedy to be considered may be a cornea transplant , also called a penetrating keratoplasty (PK or PKP).
How to treat progressive keratoconus?
Treatments for progressive keratoconus include: 1. Corneal crosslinking. This procedure, also called corneal collagen cross-linking or CXL, strengthens corneal tissue to halt bulging of the eye's surface in keratoconus. The aim of corneal cross-linking is to strengthen the cornea by increasing the number of "anchors" that bond collagen fibers ...
Why does keratoconus bulge forward?
Research suggests the weakening of the corneal tissue that leads to keratoconus may be due to an imbalance of enzymes within the cornea. This imbalance makes the cornea more susceptible to oxidative damage from compounds called free radicals, causing it to weaken and bulge forward.
What causes keratoconus in the eye?
Keratoconus also is associated with: 1 Overexposure to ultraviolet rays from the sun 2 Eye rubbing 3 A history of poorly fitted contact lenses 4 Chronic eye irritation
What is the condition where the cornea is distorted?
Keratoconus is a progressive eye disease in which the normally round cornea thins and begins to bulge into a cone-like shape. This cone shape deflects light as it enters the eye on its way to the light-sensitive retina, causing distorted vision.
What are the symptoms of keratoconus?
Keratoconus signs and symptoms. As the cornea becomes more irregular in shape, it causes progressive myopia and irregular astigmatism to develop, creating additional problems with distorted and blurred vision. Glare and light sensitivity also may occur.
What is the purpose of corneal crosslinking?
The aim of corneal cross-linking is to strengthen the cornea by increasing the number of "anchors" that bond collagen fibers together. (Diagram: Boxer Wachler Vision Institute) There are two versions of corneal crosslinking: epithelium-off and epithelium-on.
What is the condition called when the cornea is distorted and develops a cone-shaped bulge?
The word Keratoconus comes from two Greek words: kerato (cornea) and konos (cone). Keratoconus is a degenerative disorder of the eye in which the shape of the cornea, which is usually round, is distorted and develops a cone-shaped bulge, resulting in reduced vision.#N#Keratoconus is a relatively common condition. It affects one person in two thousand, occurs around the world and is quite common in the Middle East. Corneal keratoconus usually affects both eyes asymmetrically, and usually occurs in people between the ages of 10 to 25 years. The condition may progress for 10 years or more and then slow down or stabilize. As the condition progresses, vision becomes distorted and blurred, with increased sensitivity to light and glare.
Can I use contact lenses for myopic astigmatism?
However, they should be fitted by a contact lens specialist.#N#Toric Implantable Contact Lenses are generally used to treat high myopic astigmatism in patient who can see well with glasses. But if vision with glasses not good it may be used after improving corneal shape with an intracorneal ring or with very limited therapeutic Eximer laser correction. It can eliminate the need for optical aids altogether and in some patient’s results in improved vision and balance between the two eyes.
Can you use lasik for Keratoconus?
Keratoconus patients are not candidates for Lasik or normal laser correction. However, some patients benefit from limited PTK using corneal surface eximer laser correction to improve the surface irregularity of the cornea, when contact lenses cannot be tolerated. PTK is always combined with corneal cross linkage, undertaken either during the same procedure or afterwards. Patient should be aware it is not to get rid of the glasses.
Is corneal transplantation successful?
Out of all types of organ transplant surgeries (heart, lung, and kidney), corneal transplantation is the most widespread and successful of these.
Why does my cornea enfeeble?
This deficiency causes the cornea to be more vulnerable to oxidative damages caused by free radicals.
Can keratoconus be treated with contact lenses?
One of the treatments for keratoconus includes the use of lenient contact lenses/eyeglasses for the early stage. But as the cornea continues to thin and change in shape, rigid gas spongy contact lenses can be prescribed to correct the vision. Listed below are some of the possible treatments for keratoconus:
Can you put contact lenses in one eye?
Gas-permeable contact lenses dome above a cone-shaped cornea can be uncomfortable. That’s why some eye care experts practice “piggybacking” two varieties of contact lenses in one eye. You can do this by placing a soft lens over the eye before fitting a gas permeable lens over that soft lens. This increases the comfort of the wearer, since the soft lens acts like a suppressing pad under the stiff GP lens.
Can soft contact lenses cause keratoconus?
If the use of eyeglasses or soft contact lenses may not manage the progress of keratoconus, there are gas permeable types of contact lenses. This type contact lense domes above the cornea, replacing its unnatural shape with a smooth, uniform bending surface to improve vision.