Keratoconus is a corneal condition where the normal round shaped cornea develops a thinning area leading to a “bulged” or ectatic shape. In simple terms, this means that the cornea, instead of being round like a soccer ball, the cornea becomes oblong like a football. This distortion usually begins in the late teens or early twenties and can progress over time. As the keratoconus progresses, the cornea bulges and thins, becoming irregular and sometimes forming scars.
Signs and Symptoms
These can range from blurry vision to significant distortion. Occasionally glasses cannot correct the vision and a patient will need a rigid contact lens to obtain the suitable vision. It is not uncommon for each eye in one person to progress at different stages and one eye to have a more severe distortion than the other.
How is Keratoconus Treated?
Initially, glasses or contact lenses may suffice to obtain good vision.
INTACS® prescription inserts are used for keratoconus patients who are contact lens intolerant or patients who are unable to achieve suitable vision with glasses or contacts. Placing INTACS® in the periphery of the cornea causes the center of the cornea to flatten to a more normal dome shape. The goal of INTACS® is to provide the patient with improved functional vision and better comfort with contact lenses or glasses. In many cases, INTACS® can delay or even eliminate the need for a cornea transplant.
Corneal Collagen Crosslinking (CXL) is an alternative treatment for patients with mild to moderate, progressive keratoconus.
This procedure is not FDA approved at this time.
CORNEAL TRANSPLANT may become necessary if the disease has progressed and optimal vision can not be obtained with other modalities. A donated cornea is used to replace the diseased tissue and sutures are placed to allow healing. The rehabilitation time can range from a few months to a year. Though most of the cornea is involved in keratoconus in some circumstances, if the lower layers are intact, a DALK (DEEP ANTERIOR LAMELLAR KERATOPLASTY) can be performed by our surgeons at Dulles Eye Associates. A DALK can leave the lower layer intact allowing for quicker healing and less rejection. Only a few surgeons in the country are trained and able to perform this surgery due to technical difficulty.