Chapter k 10🧠 Keratoconus (Overview)

 

Keratoconus is a progressive eye condition where the cornea becomes thin and starts to bulge outward into a cone shape. This leads to blurred, distorted vision and high astigmatism.

• It usually begins in the late teens or early 20s
• It often affects both eyes
• Vision typically worsens over 10–20 years
• It may eventually stabilise

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👁️ Symptoms

People with keratoconus may experience:

• Blurred or distorted vision (wavy or hazy images)
• Sensitivity to light and glare (especially at night)
• Frequent changes in glasses prescription
• Eye irritation and rubbing
• Sudden worsening of vision in advanced cases
• Temporary clouding of vision in severe episodes

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⚠️ Causes and Risk Factors

The exact cause is not fully known, but it is thought to be a mix of genetic and environmental factors:

• Family history (around 1 in 10 cases)
• Excessive eye rubbing (can speed up progression)
• Chronic eye allergies or irritation
• Linked conditions:
  • Down syndrome
  • Marfan syndrome
  • Ehlers-Danlos syndrome

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📊 Stages and Progression

Keratoconus changes over time:

• Early stage
  • Can often be corrected with glasses or soft contact lenses
• Progressing stage
  • Cornea becomes steeper and thinner
  • Glasses become less effective
• Advanced stage
  • Requires rigid gas permeable (RGP) or scleral contact lenses
• Severe stage
  • May need:
    • Corneal collagen cross-linking (to slow or stop progression)
    • Corneal transplant (in severe cases)

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💡 Complications

In some cases, keratoconus can lead to:

• Severe vision loss (not fully correctable with glasses)
• Corneal scarring
• Acute hydrops (sudden corneal rupture causing swelling and pain and temporary vision loss)

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🚫 Important Note

• LASIK surgery is usually not recommended
• It can significantly worsen keratoconus

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🏥 Treatments

Treatment depends on severity:

• Glasses (early stage)
• Soft contact lenses
• Rigid gas permeable (RGP) lenses
• Scleral lenses
• Corneal cross-linking (to strengthen cornea)
• Corneal transplant (advanced cases)

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📌 Key Idea

Keratoconus is a long-term, progressive eye condition, but many people can manage it well with the right treatment and regular eye care.

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