Keratoconus is an eye condition that affects the cornea, causing it to become thin and bulge outwards into a cone shape. This results in distorted vision, blurry vision, and sensitivity to light. While there is no cure for keratoconus, there are several treatment options available that can help manage its symptoms and improve vision. Recent studies have shown that keratoconus may affect one in 2,000 people in the United States or higher in certain populations or age groups.
Understanding Keratoconus: Causes And Its Progression Rate
Studies show men are more commonly affected by keratoconus than women are. Other factors associated with an increased prevalence of keratoconus include excessive eye rubbing, eye allergies, contact lens wear, and living closer to the equator.
Keratoconus is a progressive condition. Unfortunately, it is difficult to predict the speed and severity of the progression. There is hope that the disease will slow down and not worsen. Slowing down the progression of Keratoconus can only partially be guaranteed. Even with glasses or contact lenses, keratoconus can continue to progress.
Is Keratoconus Genetic?
While the exact cause of keratoconus is unknown, genetics may play a role in its development. Having a family member with keratoconus increases one’s risk of developing keratoconus. Research suggests a 1 in 10 chance of a blood relative having keratoconus if the condition is present in the family. Researchers have linked genetic conditions like Down syndrome to an increased risk of developing keratoconus.
Treatment Options for Keratoconus
There are several treatment options available for people with keratoconus. These include contact lenses, corneal cross-linking, and corneal transplant surgery. Each of these treatments has its benefits and drawbacks, and the best option for you will depend on the severity of your keratoconus and your individual needs and preferences.
Contact Lenses for Keratoconus
Contact lenses are one of the most common treatment options for keratoconus. Several types of contact lenses are available for people with keratoconus, including soft contact lenses, gas-permeable contact lenses, and scleral lenses. Contact lenses create a smooth and regular surface over the cornea, which can help improve vision.
Rigid Gas Permeable (RBP) Lenses
For decades, people have been using Rigid Gas Permeable (RGP) lenses, formerly known as “hard lenses,” to treat keratoconus. Despite developing newer contact lens technologies, many older patients with keratoconus rely on effective RGPs. These lenses can correct higher-order aberrations and improve vision over glasses.
However, the primary drawback of RGPs is the initial discomfort of wearing them. Patients may feel a sensation of lens awareness and experience excessive tearing when wearing them for the first time. Many patients have adapted to the feeling of RGPs and continue to wear them. It takes some time to adjust to RGP lenses, but their incredible clarity of vision is worthwhile.
There are various ways to fit RGP lenses, including using a fitting set or custom-designing lenses based on patient eye measurements. However, fitting contact lenses for keratoconus can be challenging, and multiple visits and lenses may be necessary to achieve the best comfort and vision. The lenses must fit to provide optimal comfort and vision.
Hybrid Contact Lenses are a type of contact lens that combine the benefits of a rigid gas-permeable lens with a soft contact lens. The rigid gas-permeable lens is located in the center of the lens, while the soft contact lens material forms a skirt around the edges. This design can be more comfortable for some patients than traditional RGP lenses, as the soft skirt feels less abrasive during blinking. Hybrid lenses provide the clarity of vision associated with RGPs while offering improved comfort. Although less durable than RGP or scleral lenses, hybrid lenses are often replaced more frequently for optimal performance.
Scleral lenses are rigid contact lenses larger than RGPs and cover the white part of the eye, called the sclera. They offer two significant benefits over other types of contact lenses. They are more comfortable because they rest on the sclera with fewer nerve endings than the cornea. Scleral lenses are more stable in the eye and do not move around when you blink. Because they vault over the cornea, they do not touch it, providing better comfort. The rigid material creates a smooth surface for light to pass through, resulting in clearer vision.
Due to significant technological advancements, scleral lenses have become a game changer in recent years. They are particularly effective for fitting corneas with severe scarring after surgeries went wrong, or suffering from extremely dry eyes.
However, inserting scleral lenses can be slightly more complicated than other contact lenses. Proper insertion and care require special tools and solutions, unlike other lenses that can be placed directly into the eye.
Can You Achieve Perfect Vision With Keratoconus?
While perfect vision may not be achievable with keratoconus, significant improvement in vision is possible with appropriate management and treatment. Glasses or contact lenses can help correct vision in the early stages of the condition, but as keratoconus progresses, specialized contact lenses such as scleral lenses may be necessary. In some cases, medical professionals may recommend corneal collagen cross-linking (CXL) or other surgical procedures to stabilize or improve the shape of the cornea.
The goal of treatment is not to achieve perfect vision but to improve vision to a level that allows for comfortable and functional daily activities. It is vital for individuals with keratoconus to work closely with their eye care provider to develop a personalized treatment plan that best suits their individual needs.