Keratoconus

A progressive thinning of the cornea causing it to bulge and rob you of the ability to lead a normal life
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Who gets keratoconus?

Between 1 in 500 and 1 in 450 people get keratoconus. It usually first affects people in puberty.

YOUR CORNEA IS THINNING AND BULGING – LIKE A HERNIA

While you may not notice anything wrong in its very early stages, an optometrist may tell you that you have early signs of keratoconus. Unchecked, you’ll notice an inability to focus properly, mild blurring of vision, slightly distorted vision, where straight lines look bent or wavy. You may have an increased sensitivity to light and glare. You may see redness in your eyes and experience swelling. It may be getting worse, quickly. In later stages of keratoconus you experience more blurry and distorted vision. Your short-sightedness or astigmatism prescription may change fast, requiring you to replace your glasses more often. Your contact lenses may no longer fit properly and become uncomfortable.

KERATOCONUS CAN BE A PAINFUL CONDITION LEADING TO EMOTIONAL EXHUASTION

Before corneal cross-linking, patients can feel exhausted by the disease and emotionally spent. Many report it’s an exhausting condition that results in non-stop blurriness and feeling pain when putting in contact lenses.

THE IMPACT OF KERATOCONUS ON YOUR DAILY LIFE CAN BE COLOSSAL

Without the contact lenses that might cause you significant grief, you might be house-bound, unable to work, study, read, play or exercise. Performing the most basic daily living tasks can be difficult. You may feel vulnerable in unfamiliar environments, especially if you have no easy access to safe facilities to clean your lenses.

YOUR KERATOCONUS MAY CHANGE HOW OTHERS SEE YOU

Some patients report that they become quiet, introverted and generally discombobulated if forced to remove their glasses for long-term periods (such as, during a long-haul flight). One of the most frustrating things patients mention is people telling them to wear contact lenses instead of glasses, given they give them so much grief. But without the glasses, they can’t see.

A STABLE EYE IS A GOOD EYE

If you suffer from keratoconus, you’re tired. Unfortunately, many well-meaning GPs and even optometrists are unfamiliar with the latest advances in stabilising and, in some cases, even reversing keratoconus. They might advise you to wait until it worsens to get a corneal transplant. However, when you experience the weight that will lift off your shoulders when your eye becomes stable, you’ll know you’ve made the right decision to have corneal cross-linking.

Vision correction enables you to experience a richer life without spectacles or contacts

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Supplementary information about keratoconus

In my expert hands, you certainly don’t need to know all of the information I’ve included in the toggles below. If you’d like to know how it all works, however, open them and learn more.

Keratoconus is a condition where the cornea, the front window of the eye, becomes thinner, loses its strength and begins to warp out of shape progressively. About 1 in 450 to 1 in 500 people get keratoconus.

Keratoconus affects your cornea, the transparent dome-shaped window at the front of your eye. In keratoconus, your cornea becomes weaker causing it to bulge outwards in an irregular shape. Keratoconus usually develops in your teens or 20s and can worsen over time.

The cause of keratoconus is not completely understood but there is no doubt that a combination of genetic factors and environmental factors play a role. Research tells us that it is not enough to have the collection of genes that place a person at risk of developing keratoconus.

There is also an environmental factor which triggers it. In some patients this is allergy and in others, it is repeated rubbing of the eyes. Whatever the environmental trigger is, it results in the collagen layers of the cornea losing their strength causing the cornea to lose its shape.

Keratoconus examination in London
Essential components of an examination are:

  • refraction (spectacle test)
  • ocular examination
  • a dilated fundus examination to check the health of the eye and retina
  • a PentacamⓇ scan.

I, or a member of my highly-trained team, can precisely measure the amount of regular and irregular corneal astigmatism with a sophisticated scanner called a PentacamⓇ.

The primary treatment plan for keratoconus is to try and correct the vision problems caused by the irregular, cone-shaped cornea.

Surgical treatments are available to work to improve the shape of the cornea to give a better level of vision.

A treatment called collagen cross-linking can help to slow down the development of keratoconus. In more severe cases, corneal transplants can improve sight to a reasonable level.

Will collagen cross linking make my vision better?
Collagen cross linking will not change the shape of your cornea or improve you vision. It will simply strengthen your cornea and lock in the shape that it currently has. Other vision correction procedures will be necessary to reduce or eliminate your glasses prescription if you desire.

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Compare keratoconus with other relevant eye conditions

Eye conditions are frequently misunderstood, so here’s a quick overview of the ones I most commonly treat

ASTIGMATISM

Astigmatism is an imperfection in the shape of your eye’s cornea or lens. Usually, the cornea and lens are round or spherical like a football. In eyes that have astigmatism, the cornea and or lens of the eye are oval in shape like an egg. As a result, light rays focus on a blurred oval shape on the retina rather than as a single sharp image. Learn more about astigmatism

Treatments for astigmatism

SHORT-SIGHTEDNESS

Short-sightedness is also known as Myopia.

Short-sightedness (or myopia) is an eye condition where the focusing power of the eye is too strong. For that reason, if you’re short-sighted, you need to wear negative power lenses to reduce the focusing power of the eye. Doing so brings the image of the world into focus on our retina. Learn more about short-sightedness

Treatments for short-sightedness

LONG-SIGHTEDNESS

Long-sightedness is also known as Hyperopia or Hypermetropia.

Hyperopia or long-sightedness is an eye condition where the focusing power of the eye is too weak. For that reason, if you have long-sightedness, you need to wear positive power lenses to increase the focusing power of the eye and bring the image of the world into focus on our retina. Learn more about long-sightedness

Treatments for long-sightedness

DRY EYE

The term “dry eye” covers many different eye conditions where an imbalance in the volume or quality of the tears results in inflammation and damage to the surface of the eye. Patients have varying degrees of dry eye symptoms from occasional discomfort and stinging to severe pain and inability to see. Learn more about dry eye…

PRESBYOPIA

Presbyopia is the eye condition which causes people aged 45 and older to need reading glasses. The ageing of the eye’s natural lens which stiffens and loses its ability to focus causes presbyopia.

Treatments for presbyopia

CATARACT

Cataract is the term we use to describe the changes that occur when the lens of the eye loses its transparency and changes from appearing like a crystal clear window to appearing like a misted window like frosted glass. Learn more about cataract

Treatments for cataract

RECURRENT CORNEAL EROSION

Recurrent corneal erosion is a painful eye condition where there are episodes of severe pain on waking which resolve over a few days to a week only to reoccur again in the future. Learn more about recurrent corneal erosion

Treatments for recurrent corneal erosion

  • Laser Phototherapeutic Keratectomy (PTK)

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About the author

Mr Alex J. Shortt | Consultant Ophthalmic Surgeon

MB BCh MSc PhD FRCOphth PGDipCatRef

I’m Alex Shortt, a highly trained academic researcher and Consultant Ophthalmic Surgeon based in London’s famous Harley Street medical district. I trained and worked as a consultant for 14 years at London’s Moorfields Eye Hospital. I specialise in advanced technologies for correcting vision, including stem cell cataract surgery, implantable contact lenses and laser vision correction.