Keratoconus

What is keratoconus

Keratoconus is a rare and little understood eye disease in which the cornea begins to thin and takes on a conical (conical) shape instead of the usual spherical shape. The fibers that make up the cornea change their structure, become less durable, so the cornea bulges forward due to intraocular pressure. In this case, the disease, as a rule, simultaneously affects both eyes, although it develops slowly and imperceptibly, it greatly impairs vision.

Causes of Keratoconus

What exactly causes the development of keratoconus, experts still find it difficult to say for sure. The disease occurs in both men and women, and most often in adolescence or young age (up to 35 years). The factors provoking the development of keratoconus usually include: unfavorable ecology (for example, increased background radiation), disorders and diseases of the endocrine system and metabolism of the body, eye injuries, and also a hereditary factor. Therefore, if your relatives have been diagnosed with keratoconus, it is better to undergo regular examinations by an ophthalmologist from childhood.

There are several theories regarding the causes of keratoconus. The first theory is that some peoples have a predisposition to the development of this disease – the so-called ancient peoples, among whom there are closely related marriages, as a result of which mutations accumulate in the family – for example, Armenians, Jews, Georgians. Another theory is based on the fact that a disease develops against the background of allergization. But to say for sure and exactly what causes keratoconus, no one can yet, says ophthalmologist Natalya Voroshilova.

Symptoms of keratoconus

Symptoms of keratoconus can appear very slowly, or vice versa – suddenly. As a rule, the patient first complains of blurred image contours, eye fatigue, lacrimation, and photosensitivity. Vision begins to deteriorate, a person has to squint hard to see the image. At first, the patient begins to see poorly in the dark, and over time, even during the day. Later, double vision is added, and in severe cases, the picture begins to pulsate to the rhythm of the heartbeat. This indicates that the cornea of ​​​​the eye is already so depleted that the pulsation of the vessels of the eyeball is felt.

• Poor vision (the picture is distorted at any distance).
• Ghosting (the picture may double even if you close one eye).
• Poor night vision.
• Light sensitivity (pain, tearing in bright light).
• Intraocular tension, sensation of fullness.
• The cornea becomes thinner and protrudes, taking the shape of a cone.

Treatment of keratoconus

Keratoconus is a complex and completely unexplored disease, which is very important to start treating on time, because in severe cases, you can completely lose your sight. Therefore, it is very important to consult an ophthalmologist in a timely manner for any concerns, as well as undergo preventive examinations.

Diagnostics

Diagnosis of keratoconus can be complicated by the fact that in the early stages and without additional examinations, the ophthalmologist can mistakenly diagnose myopia (nearsightedness). As a rule, the patient is prescribed glasses, and vision improves for a while, but then drops sharply again, and the disease itself worsens.

The main method used in the diagnosis of keratoconus is a biomicroscopic examination of the eye (the tissues of the eyeball are examined under magnification). The state of the cornea, its shape, the condition of the adjacent membrane are assessed. A specific sign is the Fleischer ring, characteristic of the later stages (deposition of a dark yellow pigment from iron oxide – hemosiderin along the edge of the protrusion).

Also, the doctor may recommend additional examination:

• Refractometry (measurement of the degree of refraction in the eye);
• Ophthalmoscopy (examination of the eye through transparent structures);
• Keratopachymetry (measuring the thickness of the cornea),
• Optical tomography of the eye.

Modern treatments

Treatment of keratoconus directly depends on the degree of the disease.

– At the first stage, the patient is prescribed hard lenses (corneal or scleral), which are selected in order to stop the curvature of the cornea and the development of keratoconus, as well as for optical correction. These lenses are not suitable for all patients, many complain of discomfort when wearing them, – says ophthalmologist Natalya Voroshilova.

– Crosslinking is a procedure that is aimed at strengthening the corneal tissue, increasing its thickness – for this, the corneal tissue is impregnated with riboflavin (vitamin B12) and then exposed to ultraviolet radiation for a certain time. As a result, bonds in the collagen of the cornea are strengthened, it noticeably thickens, which is clearly visible in postoperative studies, the specialist continues.

Keratoplasty is a surgical method for the treatment of keratoconus, used in the later stages of the disease, and this is already a full-fledged operation. There are several variations of keratoplasty: the most radical is penetrating keratoplasty, when the own cornea is completely cut out and replaced with a cadaver (donor transplant). With layered keratoplasty, the lower part of the cornea is left, and only the upper, damaged layers are replaced with a cadaver flap. There is also such a method as intrastromal keratoplasty: an intrastromal corneal segment made of medical plastic – polymethyl methacrylate is implanted into the cornea. Such keratoplasty not only restores the integrity of the cornea, but also improves vision and prevents its further decline.

Prevention of keratoconus at home

As ophthalmologists note, there is no prevention of keratoconus as such, because it is rather a genetic disease. Therefore, if one of your relatives has keratoconus, then it is necessary to regularly undergo an examination by an ophthalmologist in order to identify the disease in time and begin treatment.

Popular questions and answers