Keratoconus

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Overview

Keratoconus is a degenerative eye disease characterized by thinning of the cornea and its deformation (cornea will have cone-shaped).

Cone-shape deviates light beam from the eye and vision will be distorted.

Keratoconus can occur either in one eye or in both. The condition begins in adolescents or before age 20 years.


Contents

1. Overview
2. Causes
3. Symptoms
4. Diagnosis
5. Treatment
6. Prognostic
7. Ways of prevention


Causes

The exact cause of keratoconus is unknown until this time. There are many theories, but none can fully explain the underlying cause. It is believed that genetics, environmental factors and the endocrine system plays an important role in the development of this disease.

Genetics – A scientifically point of view is that keratoconus may be a condition genetically transmitted. From the currently available information there are less than 1/10 chance that a blood relative of a patient diagnosed with keratoconus to develop this disease.

Most keratoconus sufferers have other family members who have this disease. Studies have shown that an affected cornea has a lack of important fibers that structural stabilize the front of the cornea. This is why cornea has greater flexibility and will bomb out, resembling a cone.

Environmental factors – Rubbing the eye: as seen in keratoconus cornea could easily result from trauma, such as eye rubbing. IN addition to that wearing contact lenses is considered as a possible cause of keratoconus, considering that they rub the surface of the cornea, creating the shape of the cornea seen in keratoconus, but the cause remains in doubt.

Allergies – Many persons diagnosed with keratoconus reported that their strong rubbed their eyes, due to allergies that determine eye irritation and itching. However, the link between allergies and keratoconus is unclear. Unfortunately, a growing proportion of patients suffering from atopic keratoconus is registered.

Disorders such as hay fever, eczema, asthma, food allergies are considered atopic diseases. People with keratoconus are advised to avoid rubbing the eyes as much as possible.

Oxidative stress – Some studies indicate an abnormal processing of superoxide radicals in the cornea, in patients with keratoconus and involvement of oxidative stress in the pathogenesis of this disease. In keratoconus, the cornea does not have the auto-repair routine ability in certain types of damage, unlike the normal cornea.

Like any test of body, cornea creates harmful side products for cell metabolism called free radicals. Normal cornea, like any other tissue in the body has a defense system that can neutralize these free radicals so they do not destroy collagen and structural part of the cornea to prevent corneal thinning and bulging. However, in keratoconus cornea’s case, structural damage can occur.

Hormones – Another hypothesis is that endocrine system has a role in triggering keratoconus, considering that the disease is first detected at puberty and progresses. This theory is controversial and unconfirmed.


Symptoms

Early signs of keratoconus are blurred vision, frequent need to change the dioptric or blurred vision can’t be corrected with glasses. In addition to that, most times astigmatism is present too.

Manifestations of Keratoconus usually begin in later years of adolescence or around the age of 20 years. Still, it may occur anytime. Symptoms of the condition include:

- increased sensitivity to light
- difficulty of driving at night
- to the halo shape and the presence of reflections at night
- feeling the strain of the eye
- generalized headache and eye pain
- eye irritation, excessive desire of friction.

Keratoconus, especially early, can be difficult to diagnose and all the above symptoms may be associated with other eye problems. There aren’t specific manifestations of the condition.


Diagnosis

Keratoconus can be diagnosed only after slit-lamp examination. The classic signs of keratoconus that the doctor will see when examining eyes include:

- thinning of the cornea
- the presence of Fleischer ring
- Vogt striae
- apical scars.

The doctor will measure and corneal curvature. This is done by:

- keratometry – is a technique that involves measuring the corneal curvature with keratometer. Depending on the type of focus light rays, eye doctor can determine though or not curved.
- corneal topography – involves using a computerized tool that provides “maps” of the cornea dimensional.


Treatment

Contact lenses are the main treatment for most patients with keratoconus. Severe cases may require corneal transplant as a last resort.

The following technologies can delay or prevent the need for corneal transplant:

- use high frequency radio waves or corneal implant, with which will be changed the shape of the cornea and vision will be improved with contact lenses.
- corneal crosslinking involves creating new links between collagen fibers increasing the strength of the cornea and slowing the disease. The cornea can then be remodeled through a surgery to correct vision.


Prognostic

In most cases, vision can be corrected with rigid contact lenses. If required corneal transplantation results are usually positive. The recovery period can be long and patients will need contact lenses.


Ways of prevention

Most cases of keratoconus can’t be prevented, but you can take some steps to not trigger disease:

- be careful when you rub your eyes. If you rub your eyes every day, the cornea may be damaged in a way that could lead to keratoconus. Although not yet proven relationship between eye rubbing and keratoconus, if you need to rub or wipe your eyes, you should do this as gently as possible.
- follow the correct instructions if you wear rigid contact lenses. It was important that they be recommended and installed by specialists.

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