This article has been provided by Dr. Huseyin ACAR to give information about ‘Keratoconus and Its Treatment’ in general terms.
HOW IS THE STRUCTURE OF OUR EYES ?
Main function of our eyes is to perceive the coming light and to transmit it to the visual centers of our brain by means of optics nerves. This process is realized by focusing the incoming light into the nerve layers with the help of cornea and intraocular lens. Cornea must have perfect curve in order to make a good quality of focusing into the nerve layer. Losing of the regular curve shape causes cornea not able to make a good quality of focusing for the images into the nerve layer.
WHAT ARE THE CAUSES OF KERATOCONUS ?
Keratoconus happens when the cornea tissue losses its perfect curve structure and thus it turns to be conic shape. The reason for this has not been fully established yet but it is considered that it may appears by the help of environmental factors in the people prone to have such phenomena genetically as well. One of the most important environmental factors is the eye rubbing.
Image 2: Keratoconus happens when the cornea tissue losses its perfect curve structure and thus it turns to be conic shape.
WHAT ARE THE SYMPTOMS OF THE KERATOCONUS AND HOW TO TREAT ?
Keratoconus usually appears in children along with myopia and astigmatism. Children complaint about being short-sightedness. In early stages, it is very difficult to differentiate the disorder from normal myopia and astigmatism and patients in general can see at a normal level by eyeglasses. As the disease proceeds, the patients begin to complaint about not able to see well even with eyeglasses. Keratoconus is diagnosed by implementing corneal topography for the suspicious patients during examination. But in most cases the diagnosis is made during pre-excimer laser surgery work-up.
HOW TO TREAT KERATOCONUS ?
It is possible to categorize treatment of keratoconus into two groups. The first one is the stoppage procedure for the patients whose keratoconus is still advancing and the second one is the enhancement of sight for the patients whose vision is decreased.
Today Corneal Cross Linking procedure is the only method to stop the disease. Corneal Cross Linking procedure is a pain-free method but recovery period may be painful.
As for the second group in the treatment of the illness, there are many methods to enhance vision of the patients. The most frequently used methods are eyeglasses and contact lenses. Patients in early keratoconus can have sufficient visual acuity by using eyeglasses. In case that patient does not want to wear eyeglasses or cannot have good visual acuity with them, contact lenses may be an appropriate alternative. There are many types of contact lenses specifically manufactured for the keratoconus patients.
Laser treatment is another option to increase vision. It is treatment method to reshape the cornea for correction of refractive defects and corneal irregularities in the patients who do not wish using eyeglasses or contact lenses or using such methods do not yield sufficient results. This method is usually applied with the combination of corneal cross linking procedure.
Intra-corneal rings is another treatment method to enhance the sight. In this method, rings in various numbers, shapes and thickness are inserted into the cornea according to the type and stage of the illness. This method aims at correcting the conic structure of the cornea and thus transforming it back to original curve structure.
The fifth method to enhance the sight is to install a lens inside of the eye or to alter patient’s natural intraocular lenses. These methods are generally preferred in the patients of high refractive defect caused by the keratoconus.
The last treatment method in this group is the transplantation of cornea. This is preferred for the patients with whom transparency of cornea is lost or other treatment methods are considered not to have the required effect in vision.
SUMMARY
Cornea is the transparent lens located in front of our eyes and keratoconus is a disorder of cornea where the cornea losses its normal curved shape and transforms into conic shape. There is a period in which the illness advances gradually and our aim as ophthalmologists is to detect the illness at this stage and stop it. Main purpose of treatment is to stop the illness and then to provide a good visual acuity for the patient. At the moment corneal cross linking is the only method to stop the disease. In order to improve the sight of the patient, there are a lot of available methods. The best method to enhance sight should be found by consultation with the patient in terms of his or her needs.