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What happens in Keratoconus?

Degenerative thinning of the cornea leads to a change of its lens-like shape into a cone shape bulging in the central area.

This is associated with change in the refractive power of the eye and decreased vision.

What are the Symptoms of Keratoconus?

· progressive vision loss

· frequent need to change spectacles

· glare and light sensitivity

· double vision

· eye strain, pain, and headaches

What are the Risk Factors for Keratoconus?

· Eye rubbing, associated with atopy or vernal keratoconjunctivitis

· Genetic Disorders like Retinitis Pigmentosa/ Down’s Syndrome

· Connective tissue disorders

· Family history

How is Keratoconus Diagnosed?

· Slit-lamp examination by an expert.

· Retinoscopy (assessment of scissor reflex)

· Corneal pachymetry to measure the thickness of the cornea

· Computerized corneal topography and Corneal Surface Imaging- These evaluate the front and back surface changes of the cornea

How is Keratoconus Treated?

Keratoconus patients should be monitored regularly by an expert to recognise any worsening of the condition and start treatment at the optimal time.

1/ Glasses/ Contact Lenses- Patients with early keratoconus may not need any intervention except for correcting their vision with Spectacles or Contact Lenses.

2/ Medication- Patients who suffer with conditions like atopic conjunctivitis are treated with eye drops and oral medications to prevent eye rubbing and thus progression.

3/ Collagen Cross Linking -Patients who have progressive disease are treated with Collagen Cross Linking to prevent further change and stabilize the condition. This treatment has revolutionized the management of keratoconus by stopping progression and eliminating the need for corneal transplantation.

4/ ICRS- Intra Corneal Ring Segments are implantable surgical devices used in stable patients (or after cross linking) to improve the vision.

5/Corneal Transplant- This procedure is carried out in patients with advanced disease to restore vision. It is a major surgical procedure with significant risks and morbidity, therefore it is very important to recognize keratoconus early and try to stabilize it.

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