Keratoconus



Miami KeratoconusA fairly common occurrence, keratoconus occurs when the middle part of the cornea bulges outwards, forming a sort of cone-like shape. This reduces your vision and distorts it (astigmatism), and makes it blurry (either nearsighted (myopia) or farsighted (hyperopia). Keratoconus affects about 1 in every 1,000 people. Keratoconus often begins in the teenage years, but can occur at any age and usually occurs without other eye diseases. In some cases, keratoconus is diagnosed in pediatric patients while in other cases it may not develop until adulthood.

Symptoms

Symptoms are mostly innocuous, as the main complaint is deteriorating vision. Most people complain about a minor blurring and go to see their eye doctor for reading or driving glasses. In some cases, however, vision rapidly deteriorates and night vision becomes extremely poor. Some people notice the vision in one eye is significantly worse than in the other, but usually the disease affects both eyes.The classic symptom of keratoconus is “ghost” images – called monocular polyopia. What that means is that instead of just seeing one point of light, the person sees many images, all spread out in a random order. The pattern of distorted light doesn’t tend to change from day to day.Other symptoms include a sensitivity to bright lights, called photophobia, eye strain from squinting to focus on objects, or itchy eyes.

 Causes

The National Eye Institute (part of the National Institutes of Health) has identified several causes of keratoconus, including genetics and eye rubbing. Interestingly, in patients who have one eye with more advanced keratoconus, patients will frequently report that they rub that eye more often or more intensely than the other eye.

Other potential causes include eye diseases -- such as retinitis pigmentosa, retinopathy of prematurity, or vernal keratoconjunctivitis -- or systemic diseases, such as Down’s syndrome or Leber’s congenital amaurosis.

Treatment

While patients will be prescribed glasses or contact lenses, there is only one treatment for stopping the progression of keratoconus: Corneal Collagen Crosslinking or "CXL". Without treatment, some patients with keratoconus can progress to a point where corneal scarring develops, and the only treatment that will restore vision is a corneal transplant. 

Corneal Collagen Crosslinking CXL

Over the past decade, a treatment has been developed that can actually prevent keratoconus from worsening, and this is considered the standard of care treatment in countries throughout the world. This treatment is called corneal collagen crosslinking with riboflavin (CXL), and works by strengthening the cornea and halting the condition from worsening. The treatment takes about an hour.

Corneal Crosslinking has now officially been FDA approved for use in the United States as of April 2016. Before this exciting approval, we at the Center for Excellence in Eye Care were one of several institutions nationwide that were conducting clinical trials on the procedure in anticipation of U.S. regulatory approval. Multiple studies involved centers around the nation showing that cross-linking was both safe and effective.  We are very excited to announce its approval and that we continue to offer this procedure to keratoconus patients at our practice. 

To determine if you are a candidate for Corneal Crosslinking, please call our office for a complimentary evaluation today at 305-598-2020! To visit our Miami cornea crosslinking website, see this link - www.miamikeratoconus.com

Corneal Transplant

If your doctor has determined you need a cornea transplant, it is likely you will still need corrective lenses after the procedure. About 60% of people still have to wear contact lenses after corneal transplants. In some cases, laser vision correction can be performed to reshape the cornea after a corneal transplant procedure.

Intacs

Another procedure that is sometimes used for keratoconus is called Intacs.These inserts are placed in the cornea and can reshape the cornea. These have been shown to be useful, but they only slow down the progression of keratoconus; they are not a cure and cannot reverse or stop the disease.

Schedule an Evaluation!

Although keratoconus is a challenging condition for patients, the recent advances in treatments have greatly improved the long term visual results of patients. Seeking evaluation with an eye care professional to discuss the various options is important, because the sooner that patients initiate treatment (such as with corneal crosslinking), the more likely a patient will preserve very good useful vision. Please call us at 305-598-2020 and make an appointment with one of our Corneal Specialists today!

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