The condition known as keratoconus affects one in every 2,000 Americans. It is more prevalent in teenagers and young adults.
The cornea is the clear tissue covering the front of the eye. Normally, the cornea has a dome shape like a ball. With Keratoconus, however, the typically round, dome-shaped cornea progressively thins and weakens, causing the development of a cone-like bulge and optical irregularity of the cornea. This abnormal curvature changes the cornea’s refractive power, producing moderate to severe distortion and blurriness of vision. Keratoconus typically appears in individuals who are in their late teens or early twenties, and may progress for 10-20 years, and then slow or stabilize.
WHAT CAUSES KERATOCONUS?
Tiny fibers of protein in the eye called collagen help hold the cornea in place and keep it from bulging. When these fibers thin and become weak, they cannot support the shape of the cornea. The tendency to develop keratoconus is probably present from birth and it appears to run in families. If you have been diagnosed, it’s a good idea to have your children’s eyes checked, starting by age 10.
The changes in the shape of the cornea can result in blurred vision, glare and halos at night and the streaking of lights. Because of this, simple tasks such as driving a car or reading a book can become very difficult. In most people who have keratoconus, both eyes are eventually affected, although not always to the same extent.
The most accurate diagnostic test is called corneal topography which creates a map of the curve of the cornea. A slit-lamp examination of the cornea can diagnose the disease in later stages. A test called pachymetry can be used to measure the thickness of the cornea as well.
Laser vision correction surgery, also known as LASIK, can be dangerous for people with keratoconus. Anyone with even a small-degree of keratoconus should not have LASIK surgery.
HOW IS KERATOCONUS TREATED?
Treatment usually starts with new eyeglasses. Sometimes vision cannot be corrected with glasses and rigid, gas-permeable contact lenses are needed. For many years there have been limited treatment options for those with keratoconus. Conductive keratoplasty, or high-frequency radio energy, can be used to change the shape of the cornea so contact lenses may work better. Corneal implants called intracorneal rings could also be used to change the shape of the cornea. The last line of treatment for keratoconus is a corneal transplant, which involves removing the center of the cornea and replacing it with a donor cornea.
In 2016, the FDA approved Avedro Inc.’s corneal collagen cross-linking system (KXL) for the treatment of progressive keratoconus and post-LASIK ectasia. Wolfe Eye Clinic acquired this technology upon FDA approval for treatment of patients in Iowa.
WHAT IS CORNEAL CROSS-LINKING?
Corneal cross-linking is a minimally invasive outpatient procedure that combines the use of UVA light and Vitamin B2 eye drops to add stiffness to corneas which have been weakened by disease. They are the first and only therapeutic products for corneal cross-linking which have been FDA approved to treat progressive keratoconus. Together, they create new corneal collagen cross-links which results in a shortening and thickening of the collagen fibrils. The FDA approval of the KXL System offers an effective treatment for patients who, until recently, had no therapeutic options to limit the progression of this sight-threatening disease.
Wolfe Eye Clinic has experts in keratoconus. Corneal cross-linking candidacy evaluations and treatments are available in our Cedar Rapids and Des Moines offices. We offer complete keratoconus and corneal disease expertise throughout Iowa, including Ames, Cedar Falls, Cedar Rapids, Des Moines, Fort Dodge, Iowa City, Marshalltown, Ottumwa, Spencer, Waterloo, and Pleasant Hill.
Please contact Wolfe Eye Clinic at 1-800-542-7956 to ask any corneal disease or keratoconus-related questions or to schedule an appointment with one of our corneal disease specialists: Dr. Steven Johnson, Dr. Todd Gothard or Dr. Matthew Rauen.