It refers to the condition in which your cornea -a transparent part of your eye that covers the iris and the pupil and is responsible for allowing light inside your eye and protecting it against infections- starts thinning and gradually bulges into a cone shape. A cone-shaped cornea causes blurred vision and may cause sensitivity to light and glare. Usually, it occurs in both eyes but in some cases, it might affect one eye more than the other.

Symptoms Of Keratoconus

The signs and symptoms of keratoconus may keep changing as the disease progresses. Usually, the most common symptoms include,
  • Blurred vision 
  • Increased sensitivity to bright light and glare
  • Changing eye power with frequent changes in eyeglass prescriptions
  • Sudden worsening or clouding of vision
  • Double vision

Causes Of Keratoconus

The causes of keratoconus are hard to determine and some researchers speculate that it’s related to genetic and environmental factors. Generally, given the existing data of those diagnosed with keratoconus, certain causes have been linked to an increase in the risk for keratoconus, they include,
  • Not having enough protective antioxidants in your cornea. This can weaken your collagen and lead to an increase in harmful byproducts in the eye, thus bulging your cornea.
  • A family history of Keratoconus.
  • Rubbing your eyes vigorously
  • Certain conditions like retinitis pigmentosa, Down syndrome, Ehlers-Danlos syndrome, hay fever, and asthma also increase your chances of being affected with Keratoconus.
  • Inflammation from eye allergies, asthma, or atopic eye disease can break down the tissue of the cornea
 

Diagnosis

There are mainly four types of tests that are used to properly diagnose keratoconus. They include,

Eye Refraction: In this test, our eye doctor uses special equipment to measure your eyes to check for vision problems. Our ophthalmologist might ask you to look through a device that contains wheels of different lenses, known as the phoropter to accurately judge which combination gives you the sharpest vision. Some doctors may use a hand-held instrument such as the retinoscope to evaluate your eyes. 

Slit-Lamp Examination: In this test, a vertical beam of light directs into your eye and then through a low-powered microscope, he might asses your eye. To diagnose keratoconus, they might evaluate the shape of your cornea and looks for other potential problems and conditions in your eye.

Keratometry: In this test, your eye doctor focuses a circle of light on your cornea to measure the reflection and examine the basic shape of your cornea.

Computerized Corneal Mapping: These include specialized photographic tests, such as corneal tomography and corneal topography, which are used to record images to create a detailed shape map of your cornea. Corneal topography can also measure the thickness of your cornea and can often detect early signs of keratoconus before the disease is externally visible.

Besides these tests, your doctor might also review your medical and family history for a more accurate diagnosis.

Treatment For Keratoconus

Treatment for Keratoconus depends on the state of your condition and the rate at which it’s progressing. Generally, there are two ways to treat your disease,
  • Slowing the rate of progression
  • Improving your vision
The methods of treatment for keratoconus usually involve regular usage of eyeglasses and lenses that are tailored to treat and manage Keratoconus.
Eyeglasses or Soft Contact Lenses:
Glasses of soft contact lenses can correct Keratoconus in its early stages by helping manage the blurry vision caused by Keratoconus. However, this might mean you need to make frequent changes in your eyeglasses and lens prescription as the shape of your corneas keeps changing.
 
Hard Contact Lenses:
These are the next step in treating your Keratoconus and they can feel uncomfortable at first but the wearer can get used to wearing them as time passes. Hard lenses are usually tailored to fit the shape of your cornea.
 
Piggyback Lenses:
This is usually recommended if the patient finds wearing hard contact lenses too uncomfortable, so the doctor recommends “piggyback lenses”, in which the wearer wears soft lenses first and then wears hard lenses above it.
 
Hybrid Lenses:
These lenses have a right centre with a softer ring around the outside for increased comfort. These are also an alternative to hard contact lenses.
 
Scleral Lenses:

These are usually prescribed for a very advanced stage of Keratoconus when your cornea starts morphing into a very irregular shape. Instead of touching the cornea like regular lenses, scleral lenses sit on the white part of your eye (sclera) and hover over your cornea.Surgery is usually done if you have corneal scarring, extreme thinning, or poor vision, if the lenses or eyeglasses are not working for you, or if you can’t wear prescribed lenses.

 
Penetrating Keratoplasty:
If you have extreme thinning or corneal scarring, this surgery is used to remove or replace the central portion of your cornea with donor tissue. In simpler terms, it can be understood as a full cornea transplant.
 
Deep Anterior Lamellar Keratoplasty (DALK):
This procedure will preserve the inside lining of the cornea, known as the endothelium, which will be fully removed in case of a corneal transplant.
 

Living with Keratoconus

As keratoconus is a complicated condition that usually involves either getting used to routine methods of management in your day-to-day life. They include,
  • Avoid rubbing your eyes
  • Wear sun protection for your eyes 
  • Avoid eye allergies
  • Eat a healthy and balanced diet
  • Optimising your contact lens to the maximum.
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