Keratoconus or conical cornea is the unsymmetrical progressive thinning, steepening and protrusion of the cornea without inflammation.
Who Gets Keratoconus?
It usually starts in adolescence. Recent studies report that it is more common in men, although there is no statistical difference. It often starts in one eye and occurs in the other eye after a few years – about 5 years. After five to seven years of active initiation, it may remain dormant for a long time. It stops after 30s-40s. Its frequency is approximately 50 out of 100 000.
What are the Symptoms of Keratoconus?
It is possible to evaluate the symptoms of keratoconus according to the stages of the disease.
In the early stage of keratoconus disease;
- Mild blurred vision,
- Impaired vision such as oblique or wavy straight lines,
- Increased sensitivity to light and glare,
- Increased myopia with progressive asymmetric irregular astigmatism (often distorted vision).
- Previously good with glasses The degree of vision deteriorates and cannot be corrected with glasses.
- Astigmatism cannot be corrected with the soft contact lenses used before.
- Glare in the eyes, halo around the light, ghostly images and double vision in one eye may develop.
What are the Risk Factors?
Genetic transmission is not obvious, but there is a family history in 6-8% of cases. Some abnormalities related to keratoconus can be seen in the corneal topographies of first-degree relatives who do not show clinical signs of the disease. The incidence of keratoconus increases with scratching and rubbing the eye, many congenital eye anomalies, atopic diseases-allergy, retinitis pigmentosa (night blindness), some systemic diseases, after refractive LASIK surgery, some hormonal effects, and the use of hard contact lenses that do not pass oxygen well.
How is Keratoconus Diagnosed?
In addition to questioning the patient's complaints and detecting the findings related to the doctor's examination, imaging systems With i (corneal topography), the steep, thinned areas of the cornea and some parameters are determined comprehensively. The disease can be classified as mild, moderate and severe.
What Patients Need to Know When Keratoconus is First Diagnosed
Contact lenses will definitely be required for visual quality. The outcome of keratoconus is unpredictable, the progression is variable. The disease does not cause blindness but can affect quality of life. The patient should be checked annually or even more frequently every 6 months.
How to Treat Keratoconus?
In early cases, the degree of vision can be corrected with glasses. Contact lenses are tried when it cannot be corrected with glasses. Contact lenses do not change the course of the disease, but improve the quality of life by increasing the degree of vision.
Toric soft contact lenses can be tried in initial keratoconus. In more advanced cases, hard contact lenses with high oxygen permeability are applied for a quality vision. Currently, there are also (hybrid) keratoconus lenses that include soft lenses and hard-soft contact lenses together.
Scleral contact lenses are quite successful in advanced keratoconus.
Keratoconus Surgeries
Cross-linking: In order to stop erection in progressive keratoconus, corneal collagen cross-linking is used to increase corneal resistance and treat erection.
Corneal ring (ring application): In some cases, a ring can be placed inside the corneal stroma.
Corneal transplantation: If the patient cannot wear contact lenses, if the vision quality has decreased due to corneal scarring, different types of corneal transplantation operations can be performed. Contact lenses can also be applied after transplantation.
Importance of Early Diagnosis
The patient is warned not to rub his eye. When progress is detected in intermittent controls, corneal collagen crosslinking is performed. The patient who used contact lenses before will need to wear contact lenses after this procedure.
Complications of Keratoconus
- Acute hydrops: Cracks in the cut-off layer of the cornea lead to acute corneal edema. Vision suddenly deteriorates. Medical treatment is applied. Healing takes 6-10 weeks� it may. Scar tissue may remain in its place. Sometimes, the degree of vision may be better because this scar tissue flattens the cornea. Surgical intervention can be performed when the edema disappears after at least 3-4 months.
- Nebula: It is the fibrotic scar tissue formed under the epithelium at the top of the cornea. Makes it difficult to wear contact lenses. This scar tissue is scraped surgically or with a laser. With the flattened cornea, the degree of vision may increase. Contact lenses are applied again after the corneal epithelium heals.
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