What Is Keratoconus?
Keratoconus is a degenerative non-inflammatory disorder of the eye in which structural changes within the cornea cause it to thin and change to a more conical shape than its normal even curve. Keratoconus can cause substantial distortion of the vision, with multiple images, streaking and sensitivity to light all often reported by the patient. Though frequently thought of as a rare condition, keratoconus is the most common dystrophy of the cornea, affecting around one person in a thousand, and seems to occur equally in all ethnic groups worldwide. It is typically diagnosed in the patient’s adolescent years and attains its most severe state in the twenties and thirties.
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I had to make a last minute appointment today and I was seen right away for the consultation. I am very satisfied with the care and attention given to my condition and the subsequent recommendations and follow up.
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My experiences at Roholt Vision over 25+ years have always been completely thorough and efficient with excellent results.
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Progression Of Keratoconus
Keratoconus is a little-understood disease with an uncertain cause, and the course of its progression following diagnosis is unpredictable. The associated deterioration in vision, if in both eyes, can affect the person’s ability, for example, to drive a car legally. It does not, however, lead to blindness, and in most cases, corrective lenses are effective enough to allow the patient to continue to drive and likewise function normally. Further progression of the disease may lead to a need for surgery. A condition called post-LASIK ectasia (PLE) is a rare occurrence after LASIK which is treated the same as keratoconus.
Corneal Collagen Cross-Linking
This procedure has been shown to be very effective at slowing the progression of keratoconus. Corneal cross-linking (CXL) is a 15 minute office procedure that strengthens the cornea if it’s been weakened by keratoconus or other corneal disease. It’s use in LASIK or PRK is currently being studied; rarely it can be helpful after LASIK if the cornea seems to be unstable.
How Does Corneal Cross-Linking Work?
The minimally invasive CXL procedure involves applying liquid riboflavin (vitamin B2) to the surface of the eye, followed by treatment with a controlled application of ultraviolet light, to eliminate corneal ectasia or weakness.
Different Types Of Corneal Cross-Linking
The two basic types of corneal cross-linking are:
- Epithelium-off CXL. In this type of cross-linking procedure, the thin outer layer (epithelium) of the cornea is removed to allow the liquid riboflavin to more easily penetrate the corneal tissue.
- Epithelium-on CXL. In this procedure (also called transepithelial CXL), the protective corneal epithelium is left intact, requiring a longer riboflavin “loading” time.
Combining Corneal Cross-Linking With Other Procedures
Corneal crosslinking also can be combined with other procedures for keratoconus treatment.
The Cross-Linking (CXL) would ideally be applied early in the disease or when progression (worsening) is occurring.
Treatment Of Keratoconus (Scleral Lenses or Rigid Gas Perm Contacts)
Dr. Bradley Kubis performs contact lens fits for difficult keratoconus cases utilizing Scleral Lenses or Rigid Gas Perm lenses for patients to obtain their best vision.