What Causes Keratoconus? Because keratoconus can be found in extended families, this improper functioning of beneficial enzymes appears to have genetic causes about 5% of the time. Eye damage from keratoconus also can be linked to factors such as overexposure to sunlight, improper fittings of contact lenses, excessive eye rubbing, and continual (chronic) eye irritation. Keratoconus Treatment In the mildest form of keratoconus, eyeglasses or soft contact lenses may help. Other keratoconus treatments include: Rigid gas permeable contact lenses: If eyeglasses or soft contact lenses cannot control keratoconus, then rigid gas permeable contact lenses are an option to consider. Intacs: Intacs or corneal inserts received U.S. Food and Drug Administration approval for treating keratoconus, although the first cases in the United States were performed for keratoconus in 1999. Intacs may be needed when keratoconus patients no longer can obtain functional vision with contact lenses or eyeglasses.
How Intacs corneal implants can improve vision for Keratoconus sufferers Several studies have found that Intacs improved keratoconic participants' eyeglass-corrected vision by an average of two lines on a standard eye chart. The procedure takes only about 10 minutes. Intacs might delay but can't prevent a corneal transplant if keratoconus continues to progress. Another new procedure for treating keratoconus, known as corneal collagen cross-linking riboflavin (C3-R), is a non-invasive method of strengthening corneal tissue to halt bulging of the eye's surface. C3-R may be combined with Intacs to treat keratoconus. Progression of keratoconus was stopped in all 23 eyes of 22 patients. Most patients also had some reversal of keratoconus and minor vision improvement. Researchers concluded that this simple method of treatment might have implications for greatly reducing the need for corneal transplants for keratoconus patients. 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. Keratoconus is an irregular protrusion of the cornea, the clear surface over the colored part of the eye. Keratoconus is a slowly progressive condition often presenting in the teen or early twenties with decreased vision or visual distortion. The only clue to a keratoconus diagnosis may be from corneal measurements or a corneal topography map. San Clemente Laguna Hills Aliso Viejo Irvine Newport Beach Orange County Mission Viejo Dana Point San Juan Capistrano Laguna Beach Lake Forest Capistrano Beach Laguna Niguel Rancho Santa Margarita Trabuco Canyon Laguna Woods FootHill Ranch Costa Mesa Ladera Ranch Corona Del Mar Huntington Beach California
Keratoconus Corneal transplant or penetrating keratoplasty surgery should be considered if other treatment methods fail. About 1/2000 people will develop keratoconus. Less than 10% of keratoconics will develop the most severe form. Vogt's striaes in keratoconus What is the cause of Keratoconus? The cause of Keratoconus is unknown. What are the symptoms of Keratoconus? The typical patient with undiagnosed keratoconus complains of deteriorating vision, usually in one eye first, both at distance and near. Keratoconus patients often report multiple images, or ghosting of images and often relate a history of frequent refractive correction changes without much improvement in visual acuity. Even with appropriate contact lens correction, keratoconus patients often report fluctuating vision throughout the day and from day to day, although the measurements of visual acuity in keratoconus patients are highly repeatable. The treatment approach to keratoconus follows an orderly progression from glasses to contact lenses to corneal transplantation. Glasses are an effective means of correction mild keratoconus. A gas permeable contact lens is the most highly effective way to manage keratoconus.
In more advanced cases the cornea more distorted and specifically designed keratoconic contact lenses become necessary. Even though Keratoconus does not cause blindness most patients go on to needing contact lenses. The use of gas permeable contact lenses has been the mainstay of the optical management of keratoconus. No one design is best for every type of keratoconus. Rigid lens fitting in keratoconic eyes is however, by no means simple. Numerous lenses are often required, fitting a keratoconic eye is an art as much as a science. Normal design Keratoconic lenses Standard rigid lens designs are the simplest fitting choices and achieve their best level of success in early or mild KC. Aspheric lens designs gradually flatten from the center toward the periphery, approximating the steep cone vs. flat periphery curvature relationship seen in keratoconus. Because the nature of an aspheric lens allows for plus power in the periphery, presbyopic keratoconics may find this lens preferable if the fit is acceptable. San Clemente Laguna Hills Aliso Viejo Irvine Newport Beach Orange County Mission Viejo Dana Point San Juan Capistrano Laguna Beach Lake Forest Capistrano Beach Laguna Niguel Rancho Santa Margarita Trabuco Canyon Laguna Woods FootHill Ranch Costa Mesa Ladera Ranch Corona Del Mar Huntington Beach California
Ellip-See-Con-K and the Multi-Curve Sphere are aspheric lens by Conforma Specialty design keratoconic lenses Epicon contact lens developed for Keratoconus and difficult to fit patients! Rose K Keratoconic lens The Rose K lens is probably the most widely fitted keratoconus lens worldwide and achieves an 85% first fit success in the UK. The Rose K lens design is a fully flexible lens that works well on early to advanced keratoconus patients. Multiple parameters make fitting the Rose K lens possible for most keratoconic eyes. Flexlens Harrison Keratoconus: The newest addition to the Flexlens Keratoconus soft lens system, Harrison Keratoconus Lenses provide the design features of rigid keratoconus lenses and the other benefits.
Because they are designed from corneal topography, and the keratoconic cornea can have changes in curvature that are too detailed for the corneal map to reveal, this type of design may or may not work when the lens is placed on the eye and interacts with the ocular environment. San Clemente Laguna Hills Aliso Viejo Irvine Newport Beach Orange County Mission Viejo Dana Point San Juan Capistrano Laguna Beach Lake Forest Capistrano Beach Laguna Niguel Rancho Santa Margarita Trabuco Canyon Laguna Woods FootHill Ranch Costa Mesa Ladera Ranch Corona Del Mar Huntington Beach California
CORNEAL TRANSPLANT or PENETRATING KERATOPLASTY Deciding when to have a corneal transplant: A corneal transplant may be needed when vision cannot be corrected satisfactorily using other procedures such as contact lenses and glasses, or if painful swelling cannot be relieved by medications. When the cornea becomes "opaque" or gray/white (see right photo) from disease or injury or painful from swelling or blisters, it no longer functions as the "clear window" of the eye. It then acts more like a "soapy" window which you cannot clearly see through. Even if the rest of the eye is healthy, a cloudy cornea will obstruct clear vision. Of all the transplant surgery done today (hearts, lungs, kidneys, etc.) corneal transplants are by far the most common and successful. Once you and your eye care provider has decided a corneal transplant is necessary, your name is put on a waiting list for a donor cornea, usually this wait is short. Most eye banks are able to provide tissue for transplant surgery scheduled in advance for a specific day. Before a donor cornea is released for transplant, the eye bank tests the human donor for clarity and for the viruses that cause Herpes Simplex and AIDS. Your surgeon may request that you have a physical examination and other special tests prior to surgery. If you usually take medications, ask your surgeon if you should continue them. A corneal transplant, also known as a corneal graft, or as a penetrating keratoplasty, involves the removal of the central portion called a button (see left photo) of the diseased cornea and replacing it with clear healthy donor button. The donor cornea button is sewed into the defect created by removal of the diseased cornea. If a cataract is present, it is removed at this time. Tiny hair-thin sutures or stitches are used to anchor the graft to the host tissue (see sequence below).
The surgery itself is painless and usually done on an outpatient basis. The operating time is approximately 60-90 minutes, followed by a short recovery time. In most cases you will be allowed to go home soon afterward. The postoperative recovery is a long one, but in most cases, resumption of normal activities may occur soon after surgery with some reasonable limitations. For example, lifting heavy objects or strenuous exercise must be avoided until directed otherwise by the physician. Until the eye has healed, glasses or an eye shield must be worn to protect the eye. The sutures used to sew the donor cornea in place are barely visible and do not cause pain. It is normal for the eye to feel scratchy or irritated for the first few days following surgery. As the cornea heals, some of the stitches used to sew the donor tissue into place are removed. This can be done quite easily in the doctor's office. The final improvement in vision is gradual and occurs six to twelve months post-operatively. Once the cornea stabilizes, improved vision is usually enjoyed. The results and success in restoring vision usually depend more on the state of the original disease than the actual surgical manipulation. In quantitative terms success rates vary from 90-95 percent. In spite of the most advanced surgical techniques and the most expert surgeon you can choose, complications can and do occur. The most serious complications such as loss of vision or the eye itself are uncommon. The lesser complications are usually treatable. San Clemente Laguna Hills Aliso Viejo Irvine Newport Beach Orange County Mission Viejo Dana Point San Juan Capistrano Laguna Beach Lake Forest Capistrano Beach Laguna Niguel Rancho Santa Margarita Trabuco Canyon Laguna Woods FootHill Ranch Costa Mesa Ladera Ranch Corona Del Mar Huntington Beach California