Symptoms and signs:
As the cornea becomes more irregular in shape, it causes progressive nearsightedness and irregular astigmatism to develop, creating additional problems with distorted and blurred vision. Glare and light sensitivity also may occur.
Causes:
New 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.
Risk factors for oxidative damage and weakening of the cornea include a genetic predisposition, explaining why keratoconus often affects more than one member of the same family.
Keratoconus also is associated with overexposure to ultraviolet rays from the sun, excessive eye rubbing, a history of poorly fitted contact lenses and chronic eye irritation.
What Warnings Should I Know About Corneal Cross-Linking?
Ulcerative keratitis, a potentially serious eye infection, can occur. Your doctor should monitor defects in the outermost corneal layer of the eye for resolution.
Who Should Not Receive CXL?
The safety and effectiveness of CXL has not been studied in pregnant women, women who are breastfeeding, patients who are less than 14 years of age and patients 65 years of age or older.
What Are The Side Effects Of CXL?
In progressive keratoconus patients, the most common side effects in any CXL treated eye were haze, inflammation, fine white lines, disruption of surface cells, eye pain, reduced sharpness of vision, and blurred vision. In patients with corneal ectasia following refractive surgery, the most common side effects in any CXL treated eye were haze, disruption of surface cells, fine white lines, dry eye, eye pain, inflammation, light sensitivity, reduced sharpness of vision, and blurred vision.
These are not all of the side effects of the CXL treatment. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
Keratoconus treatment:
In the mildest form of keratoconus, eyeglasses or soft contact lenses may help. But as the disease progresses and the cornea thins and becomes increasingly more irregular in shape, glasses and regular soft contact lens designs no longer provide adequate vision correction.
The aim of corneal cross-linking is to strengthen the cornea by increasing the number of “anchors” that bond collagen fibers together.
Treatments for progressive keratoconus include:
1. Corneal crosslinking
Treatment by providing contact lenses
- Custom soft contact lenses
- Gas permeable contact lenses
- Silicone hydrogel contact lenses
- Hybrid contact lenses
- Scleral and semi-scleral lenses
- Prosthetic lenses
Surgery Option:
- Intacs (Addition Technology)
- Topography-guided conductive keratoplasty
- Corneal transplant
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