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Keratoconus

Definition. What is keratoconus?

It is a progressive thinning and stretching of the cornea. Eventually it leads to bulging of the cornea.


Symptoms:

Keratoconus causes visual distortions like ghosting, glare and blurred vision. The patient’s vision becomes progressively worse as the disease progresses.


Who gets keratoconus:

It is an inherited eye disease.  Keratoconus is generally first diagnosed in young people at puberty.  It has a strong association with excessive eye rubbing and allergic conjunctivitis and myopia [short sighted eyes]

Keratoconus usually does not progress in people older than 50 years.


Diagnosis.

Patients complain of poor vision and distorted vision. See symptoms above. On examination they are often shortsighted and spectacles may not correct the visual clarity.

The diagnosis is confirmed with topography.

Advanced keratoconus may cause obvious bulging of the cornea [Munson’s sign] but by the the diagnosis should have been made.

Neglected keratoconus may progress to hydrops of the cornea. [Severe swelling and opacification]


Treatment:

1.     Early stage keratoconus causes astigmatism that can be corrected by

a.)  Spectacles
b) Contact lenses.

2.     Corneal cross Linking:  This is a surgical procedure where an ultraviolet light and Vitamin B2 is used to increase corneal rigidity and halt the progression of keratoconus.

3.     Intracorneal ring segments.

4.     Patients with severe keratoconus may need a corneal transplant due to scarring of the cornea.  The corneal transplant is a procedure where the keratoconic cornea is replaced with a healthy donor cornea. Two techniques are used

a)  Full thickness corneal transplant. PKP. Penetrating KeratoPlasty.
b)  Partial thickness corneal transplant. DALK = Deep Anterior Lamellar Keratectomy          

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