Is cross linking a laser procedure?

Cross linking is merely a therapeutic procedure to prevent the cornea from thinning out further. It is not a laser procedure to remove glasses. You will still require glasses post procedure, though the final refraction value will be arrived at 6 months post procedure. Prior to that, temporary glasses may be used.

What is the role of contact lenses?

Contact lenses sit directly on the corneal surface, and there are various types of these lenses that have been proven beneficial in keratoconus as they regularise the shape of the cornea and flatten a steep curvature. This improves quality of vision. Before prescribing lenses, you will undergo a contact lens trial so you are prescribed lenses appropriate to your stage of the disease.

Will Keratoconus make me blind?

Keratoconus, if diagnosed early and managed appropriately, will NOT make you blind. It is not curable, but can certainly be amended. There is a sight threatening complication of advanced untreated keratoconus called acute hydrops, in which the cornea becomes so thin, that the fluid inside the eye called aqueous breaches its barrier and flows into the corneal layers, making the cornea opaque, oedematous and boggy. This too can be managed, however it is advisable to get treated before this happens if you already know that you have this condition.

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Keratoconus

What is Keratoconus?

Keratoconus is a condition that affects our cornea (the clear membrane at the front of the eye). The cornea is supposed to have a smooth regular shape and is responsible for focusing light on the retina.

In patients with keratoconus, the cornea begins to progressively become thinner usually between the late teens and early twenties. This thinning causes the cornea to protrude in the centre and assume a conical irregular shape.

Keratoconus usually involves both eyes, but one eye may be more advanced than the other.

Doctor Speaks: All about Keratoconus

Dr. Soosan Jacob

Dr. Kavitha Rao

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What are the Symptoms of Keratoconus?

Blurred vision:

Blurred vision occurs as the cornea changes shape, leading to difficulty focusing on objects clearly.
Ghosting of images:

Patients may see multiple, overlapping images, particularly in low-light conditions.
Distorted vision

Vision may appear wavy or stretched due to the irregular shape of the cornea.
Sensitivity to light

Increased glare and discomfort in bright lights are common complaints of keratoconus patients.
Glare

Patients may experience starbursts or halos around lights, especially at night.
Frequent change in glass prescriptions

A common sign of keratoconus is the need for frequent adjustments to eyeglass or contact lens prescriptions.

Causes of Keratoconus

Various genetic and environmental factors contribute to it.

Known risk factors include a family history, a tendency towards eye rubbing, history of asthma or frequent allergies and other conditions like Downs Syndrome and Ehler Danlos Syndrome.

Diagnosis of Keratoconus: Tests and Procedures

If you have the above symptoms, or if you have recently been diagnosed with corneal astigmatism and are not comfortable with your glasses, a visit to the ophthalmologist is a must.

After testing your power, you will be examined under the slit lamp biomicroscope. If there is a strong suspicion of keratoconus you will be advised a corneal scan, called a corneal topography, which maps out the thickness and shape of your cornea.

There are various types of scans to map the same, some which act as a screening tool, and others that aid in deciding further management.

Treatment and Management Options for Keratoconus

Keratoconus treatment options depend on the severity of the condition and may include:

Eyeglasses and Contact Lenses – Used in the early stages for vision correction.
Corneal Cross-Linking (C3R) – A minimally invasive procedure to strengthen the cornea and halt progression.
INTACS – Small corneal implants to reshape the cornea and improve vision.
Corneal Transplant – For advanced cases where other treatments are ineffective.

Precautions After C3R Surgery for Keratoconus

Proper post-operative care is crucial after C3R surgery to ensure a smooth recovery. Below are the do’s and don’ts to follow:

Do’s:

Use prescribed medications and follow the doctor’s instructions strictly.
Wear UV-protective sunglasses outdoors.
Attend follow-up appointments for monitoring recovery.
Rest your eyes and avoid excessive screen time.

Don’ts:

Avoid rubbing or touching your eyes.
Refrain from strenuous activities and swimming for at least a month.
Stay away from direct sunlight exposure without protection.
Do not drive until your vision stabilizes.

Written by: Dr. Diana – Consultant Ophthalmologist, Perambur

Frequently Asked Questions (FAQs) about Keratoconus

Is Keratoconus Curable or Can It Be Managed?

Keratoconus cannot be cured, but it can be effectively managed with treatments such as glasses, contact lenses, corneal cross-linking (C3R), and, in advanced cases, corneal transplants.

Can Keratoconus Progress After C3R?

In most cases, corneal cross-linking stabilizes keratoconus and prevents further progression. However, in some cases, progression can occur over time, requiring additional interventions.

What are the early signs of keratoconus?

Early signs include blurred or distorted vision, increased sensitivity to light, frequent changes in eyeglass prescriptions, and difficulty seeing at night.

What causes corneal thinning in keratoconus?

Corneal thinning in keratoconus is caused by a combination of genetic, environmental, and biochemical factors that weaken the corneal structure over time.

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What is Keratoconus?