Keratoconus in eye

Dr Sanjay Sachdeva
Keratoconus is a non inflammatory disease of the cornea which can cause a central thinning of the corneal tissues. This usually occurs sometime in the early teenage years. The thinned part of the cornea then starts to bulge forwards. When this happens, the cornea is no longer a regular shape, instead it becomes irregular and cone shaped causing the eye to become myopic and astigmatic. This then produces blurred and distorted vision.
How common is Keratoconus?
Keratoconus is estimated to occur in 1 out of every 2000 persons in the general population.  There appears to be no significant preponderance with regards to either men or women.
What Causes Keratoconus?
The characteristics of keratoconus have been known for at least 200 years, but the specific causes are still undetermined.   Several theories have been proposed:
* One scientific theory is that keratoconus is genetic in origin.  About 7% of patients have other family members with the disease.
* Another view holds that keratoconus is a degenerative condition perhaps linked to the altered balance between enzymes and inhibitors within the cornea
* Keratoconus may also be secondary to some disease processes.
* A hypothesis has also been proposed that keratoconus may involve the endocrine system (hormones) since the condition is often diagnosed in young people at puberty or in their late teens.
While the exact cause of keratoconus has not yet been determined, research into keratoconus continues and new treatment options are continually under development
What are the signs and symptoms of Keratoconus?
The initial symptoms of keratoconus are usually a blurring and distortion of vision that may be corrected with spectacles in the early stages of the condition.  Frequent changes to the spectacle correction may be required as the cornea becomes progressively thinner.
What is the usual age of onset of Keratoconus?
The onset of keratoconus can be anywhere between the ages of 8 and 45. In the majority of cases, it becomes apparent between the ages of 16 and 30 years.
Does Keratoconus affect both eyes?
Yes, keratoconus generally affects both eyes.  Only in a very small percentage of cases (<1%) is there just the involvement of one eye.  Even though keratoconus is basically a bilateral condition, the degree of progression for the two eyes is often unequal; indeed, it is not unusual for the keratoconus to be significantly more advanced in one eye.
Is Keratoconus associated with any other diseases or disorders?
Keratoconus has been associated with conditions such as hay fever, asthma, eczema, double jointedness, Down’s syndrome, Marfan’s syndrome and mitral valve prolapse.
Does Keratoconus cause blindness?
Keratoconus does not cause total blindness. However it can lead to significant vision impairment resulting in legal blindness.
What is the treatment ?
Most recent the treatment of keratoconus is C3-R (Corneal collagen crosslinking with rifoflavin)
The procedure involves UV radiation along with riboflavin drops. It has been well established that this treatment arrests the progress of keratoconus. In the most advanced cases the only treatments keratoplasty.

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