Keratoconus Treatment

Keratoconus disease, known as a type of eye disease ; It is a disease that occurs when the structure of the cornea deteriorates, it tapers, protrudes forward and becomes increasingly thinner. If it is not treated correctly and in a timely manner, it impairs the quality of vision, causes a gradual decrease in vision, and even causes serious complications leading to blindness.

The most important known factors in the development of the disease are scratching the eyes and genetic predisposition. For this reason, people who scratch their eyes frequently and have a family history of keratoconus are in the risk group.

If there are people in your family who have this disease, it is recommended that they have eye examinations at regular intervals. The most important thing in keratoconus disease is early diagnosis. If the disease is diagnosed early, the probability of successful treatment is very high.

What is Keratoconus?

Keratoconus , in its simplest definition, is the deformation of the cornea. The deformed corneal tissue tapers forward and creates a cone-shaped protrusion. The disease is precisely caused by the cornea reaching this state. The cornea is a transparent layer located on the outermost layer of the eye and has a dome-shaped structure.

The dome-shaped structure of the cornea allows light to focus in the visual field. As the dome shape deteriorates, it becomes difficult for the eye to focus. As a result, a distorted and blurry image emerges, making it difficult to perform activities such as reading a book or driving a car.

In other words, keratoconus is a disease that reduces the quality of life. Keratoconus , which has a progressive nature , is an eye disease that usually occurs during adolescence.

What are the Causes of Keratoconus Disease?

The causes of keratoconus are a matter of curiosity for many people. Although many studies have been conducted on this subject, it has not been determined exactly what causes keratoconus disease .

However, when we look at the data obtained as a result of the research , it is possible to conclude that the disease is more common, especially in individuals who scratch their eyes very frequently and whose parents have keratoconus . Based on this point, it will be possible to comment that one of the factors that cause keratoconus disease is genetic factors.

1 in 10 people with keratoconus has a mother or father who also has keratoconus. Keratoconus eye disease usually occurs in the late 10s and early 20s. Vision problems caused by the disease usually worsen over a period of 10 to 20 years.

One of the most common misconceptions about keratoconus is that the use of poor quality contact lenses can cause keratoconus. However, there is no scientific research proving this claim.

In people who are prone to keratoconus , frequent movements such as eye rubbing can cause damage to the corneal structure. For this reason, if you or your family has a diagnosed keratoconus disease , it is recommended that you avoid making movements that may cause eye damage, such as eye rubbing.

Rubbing the eyes can cause further progression of the disease as it damages the thin tissues on the cornea. If the feeling of rubbing your eyes is caused by allergies, it would be beneficial to consult a doctor. It will be possible to get rid of this habit by determining the factor that causes the allergy and applying treatment accordingly. In addition to keratoconus, eye rubbing is also known to be a negative action for general eye health.

In addition , hormonal effects on keratoconus disease , low collagen level in the cornea, intense exposure to ultraviolet rays, chicken black disease, having Down syndrome and disorders related to connective tissues are considered among the most common causes of keratoconus.

Is the incidence of keratoconus high?

The incidence of keratoconus is wondered by many people. According to many studies and statistics about keratoconus , men are more likely to get keratoconus than women. Keratoconus generally begins in adolescence and becomes stable in the 40s.

The incidence of keratoconus is known to be 5 in 10 thousand. It is possible to reduce the frequency of the disease and alleviate or eliminate complications arising from the disease, thanks to the precautions to be taken and regular screening tests.

What are the symptoms of Keratoconus?

Keratoconus symptoms appear in different ways. Although keratoconus usually affects both eyes, it can cause different problems in both eyes. Symptoms may vary over time and may be different in each eye. Symptoms of keratoconus in the early stages can be listed as follows;

• Mild blurred vision, vision becoming blurred
• Visual disturbances, especially when straight lines appear wavy or twisted
• Eye swelling and constant redness
• Sensitivity to light and sudden flashes

In advanced stages, keratoconus symptoms become much more pronounced. It is possible to list the symptoms seen in advanced cases as follows;

• Increased blurred vision or progression of visual impairments
• Rapid increase in myopia and astigmatism degrees and increased need for glasses
• Contact lenses do not fit properly due to protrusion of the cornea. As a result of this situation, situations such as the lenses not fitting the eyes or causing discomfort while in the eye may occur.

The progression of keratoconus from the early stage to the advanced stage generally takes a long time and takes years. However, in some cases, the symptoms worsen and complications occur suddenly. Sudden swelling of the cornea and permanent hardening of the cornea, known as scarring, are also likely to occur.

With the appearance of this scar tissue, called scar, the softness and clarity of the cornea begins to disappear. With this development, vision eventually becomes blurred and more distorted.

How to Diagnose Keratoconus?

Keratoconus can be diagnosed easily after a simple eye examination. However, diagnosis at an early stage can be challenging. However, in cases where a person has keratoconus disease in their family , it will become easier to detect the disease. The specialist ophthalmologist examines the cornea in detail and measures the curvature of the cornea.

Thanks to this examination, it is easily detected whether there is a shape change in the cornea. In addition, the specialist ophthalmologist can map the surface of the corneal tissue with the help of a special computer. This process is called corneal topography . Thanks to this method, it is possible to clearly detect whether there is thinning or deformation on the corneal surface.

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How to Treat Keratoconus?

Today, many different methods are used for keratoconus treatment . These methods vary depending on factors such as the patient’s eye structure, patient preferences, and the progression level of the disease, and are applied by a joint decision between the doctor and the patient.

In the early stages of the disease, there is usually no need for serious and complicated treatment. At this stage, methods such as the use of glasses are generally applied. In addition, focusing problems can be eliminated by using specially produced hard contact lenses.

However, as the disease progresses, the cornea becomes thinner and its shape deteriorates; Treatments such as the use of glasses and contact lenses are not sufficient. At this point, the need for more complex treatment arises. It is possible to list the treatment methods used for keratoconus treatment as follows;

• Use of special soft contact lenses
• Corneal cross-linking or also known as cross-linking method
• Rigid, gas-permeable contact lens
• Hybrid contact lens
• Hard – gas permeable contact lens over soft contact lens
• intracorneal ring
• Scleral or semi-scleral lens
• Topo-Guied Laser (topography guided laser)
• corneal transplant

Use of Special Soft Contact Lenses

As we mentioned before, one of the methods used in addition to the use of glasses in the early stages of the disease is known as soft contact lenses.

However, as the disease progresses, the use of soft contact lenses does not provide clear vision. For this reason, specially developed soft contact lenses for the treatment of the disease may be preferred, especially in advanced cases.

Cross-linking Treatment

Cross-linking or cross-linking therapy is known as a treatment method that aims to stop the progression of the disease.

With this treatment, vitamin B2 (riboflavin) is dropped into the eye area and after this process, the structure of the cornea is hardened with ultraviolet A light. This treatment method, which is applied using numbing drops, is completed in approximately 40 minutes.

Rigid Gas Permeable Contact Lens

The lenses used in the treatment of this disease are known as contact lenses with rigid gas permeable properties. These lenses provide a very clear image for keratoconus patients .

However, although they are not easy to use, they are not comfortable products. For this reason, it is possible to say that it is a method that is not preferred as much as possible in order to keep the patient’s quality of life at an optimum level.

Hybrid Contact Lens

Hybrid contact lens treatment, as the name suggests, is a treatment method in which soft and hard contact lenses are structurally used together. Hybrid contact lenses are made of hard materials in the middle and soft materials around them.

The middle part, which has a hard structure, provides clarity of vision, while the soft surrounding area provides comfortable use. It is known as a frequently preferred treatment method for keratoconus disease as it provides both clear vision and comfortable use .

Hard – Gas Permeable Contact Lens Over Soft Contact Lens

Lenses with hard permeability may occasionally cause scratching of the outer surface of the cornea. In such cases, both soft and hard permeable lenses are used together to protect the corneal surface.

While the soft lens placed at the bottom prevents damage to the corneal surface, the hard gas permeable lens located on the outside ensures high-level vision quality. This application is also known as piggyback .

Intra-Corneal Ring

In some cases, a ring is placed inside the cornea. In this treatment method, where a clear view is obtained, surgery is required to place the ring.

However, ring treatment is not a treatment method that completely eliminates the use of contact lenses or glasses. Therefore, it is not possible to say that it is recommended for every patient.

Scleral or Semi-Scleral Lens

Scleral or semi-scleral lenses are known as lenses with a very large structure. These lenses cover the entire cornea region over the colored part of the eye. They are preferred in some cases when it is not appropriate to use hard lenses or soft lenses.

Cornea Transplantation

If keratoconus disease is very advanced, none of the above treatment methods may provide adequate vision. If this situation occurs, it may be necessary to resort to corneal transplantation .

If symptoms are severe, the ophthalmologist may recommend a corneal transplant . With corneal transplantation, all or part of the diseased tissue is replaced with healthy tissue. Although it is a definitive treatment method, it completely eliminates keratoconus disease. There is no possibility of the disease recurring after corneal transplantation .

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