Keratoconus (KC) is a thinning disorder of the cornea that causes visual distortion. It causes the cornea to thin & bulge to a cone-like shape, distorting vision.
The earliest signs of keratoconus are usually blurred vision and frequent changes in eye glass prescription, or vision that cannot be corrected with glasses. Symptoms of keratoconus generally begin in late teenage years or early twenties, but can start at any time.
Keratoconus, especially in the early stages can be difficult to diagnose. Keratoconus requires a diagnosis from a competent keratoconus specialist trained in recognizing the symptoms , also observing signs of keratoconus through direct measurement as well as inspection of the cornea at a microscopic level using a slit lamp.
Keratoconus can usually be diagnosed with a slit-lamp examination. The classic signs of keratoconus that the doctor will see when examining your eyes include:
Corneal thinning, Fleischer’s ring (an iron colored ring surrounding the cone), Vogt’s striae (stress lines caused by corneal thinning) and Apical scarring (scarring at the apex of the cone).
A typical corneal topography map looks like this:
Corneal topography and Pentacam has facilitated the diagnosis of keratoconus, helping establish the diagnosis earlier, follow progression more accurately and differentiate keratoconus from other conditions.
The treatment involves 2 aspects –
2 Corneal Cross-linking - To Stop Progression of Keratoconus -
Corneal Collagen Cross linking (CXL) is currently the only treatment to stop progression of keratoconus and to avoid corneal transplant. CXL works by increasing collagen crosslink’s which are the natural “anchors” within the cornea. These anchors are responsible for preventing the cornea from bulging out and becoming steep and irregular. CXL has been done for over a decade with good success and has changed the way keratoconus is managed today. We are one of the pioneers of CXL treatments and offer all the techniques of CXL including accelerated cross linking and various combinations of CXL with vision enhancing techniques such as Topo PRK and INTACS.
Intacs is the trademark name for micro-thin prescription inserts which were previously used as a form of refractive surgery in the treatment of low levels of myopia or near sightedness, but has recently received FDA approval for keratoconus. Intacs are thin plastic, semi-circular rings inserted into the mid layer of the cornea. When inserted in the keratoconus cornea they flatten the cornea, changing the shape and location of the cone. The placement of Intacs remodels and reinforces the cornea, eliminating some or all of the irregularities caused by keratoconus in order to provide improved vision. This can improve uncorrected vision, however, depending on the severity of the KC, glasses or contact lenses may still be needed for functional vision.
Although only 15-20% of those with keratoconus ultimately require corneal transplant surgery, for those who do, it is a crucial and sometimes frightening decision. However, those who know what to expect before, during and after surgery are better prepared and feel more in control of their health care. In keratoconus, a corneal transplant is warranted when the cornea becomes dangerously thin or when sufficient visual acuity to meet the individual’s needs can no longer be achieved by contact lenses due to steepening of the cornea, scaring or lens intolerance. Lens intolerance occurs when the steepened, irregular cornea can no longer be fitted with a contact lens, or the patient cannot tolerate the lens.
Doctors at Asian Eye have been at the forefront for keratoconus management internationally. Dr Vardhaman Kankariya (a laser vision correction, advanced IOL and keratoconus specialist) has been trained for Keratoconus - long term fellowship - for one year at world renowned University of Crete under Professor Kymionis (Pioneer of Cross-linking management). For our keratoconus research and clinical work, we have been awarded Asia Pacific Refractive Surgery Award,
All India Ophthalmological Society – AIOS- Cornea Award and All India Ophthalmological Society AIOS - Hardia Award (Highest scientific award for refractive and corneal surgeons).
We have probably the highest scientific contribution about keratoconus in India (over 40 international publications) in peer reviewed journals such as American Journal Of Ophthalmology and British Journal Of Ophthalmology. We believe in 360 degree keratoconus care providing all aspects of keratoconus treatment (specialised CL, Cross Linking, INTACS and component corneal transplants) under one roof with team of keratoconus specialist eye surgeon and certified specialist CL fitting optometrist. This is done by utilising cutting edge equipments to diagnose and treat keratoconus as per international standards.