Keratoconus information

what is keratoconus imageKeratoconus, a progressive thinning of the cornea, is the most common corneal dystrophy in the U.S., affecting one in every 2000 Americans.

Keratoconus is more prevalent in teenagers and adults in their twenties. It arises when a focal area of the cornea thins and gradually bulges outward, forming a rounded cone shape. This abnormal curvature changes the cornea’s refractive power, producing moderate to severe distortion (irregular astigmatism) and blurriness of vision. This eye disease may also cause sudden swelling and a sight-impairing scarring of the tissue.

Quick Facts

Affects 1 in 2000 in the United States
Affects all ethnicities & both genders
First diagnosed in young people at puberty or in their late teens
Progressive until the 3rd – 4th decade

Risk Factors

Eye rubbing
Family history
Number of family members
Younger age at onset

Did you know

Dr. Berger was the first surgeon in Tampa and Central Florida to utilize Avedro Collagen Crosslinking and Femtosecond Laser Assisted Implantation of INTACS Ring Segments for the treatment of keratoconus.

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Keratoconus Causes

Keratoconus involves a complex interaction of both genetic and environmental factors, which allows a ‘two-hit hypothesis’, that is, a genetic predisposition to the corneal disease and a second hit that triggers the disease. Previously believed to be a non inflammatory condition recent studies have shown a significant role of proteolytic enzymes, cytokines, and free radicals. Increased levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), and matrix metalloproteinase (MMP)-9 have been found in the tear film possibly as the result of eye rubbing (the second hit). Eye rubbing is usually associated with atopic conditions like asthma, hay fever, excema, atopic and vernal keratoconjunctivitis.

Other conditions linked to keratoconus include sleep apnea, Leber’s congenital amaurosis, Ehlers-Danlos syndrome, Down syndrome, and osteogenesis imperfecta.

Keratoconus usually affects both eyes. At first, people can correct their vision with eyeglasses. But as the astigmatism worsens, they must rely on specially fitted contact lenses to reduce the distortion and provide better vision. Although finding a comfortable contact lens can be an extremely frustrating and difficult process, it is crucial because a poorly fitting lens could further damage the cornea and make wearing a contact lens intolerable.

In most cases, the cornea will stabilize after a few years without ever causing severe vision problems. But in about 10 to 20 percent of people with keratoconus, the cornea will eventually become too scarred or will not tolerate a contact lens. If either of these problems occur, a corneal transplant may be needed. This operation is successful in more than 90 percent of those with advanced keratoconus. Several studies have also reported that 80 percent or more of these patients have 20/40 vision or better after the operation.

Eye Rubbing

Eye rubbing is a hallmark sign of both allergic eyes AND keratoconus. All eye rubbing is not the same and tends to have different patterns, depending on whether allergic eyes or keratoconus is the cause. Check this out:

Eye rubbing and keratoconus

The allergic eye patient tends to complain of “itchy eyes” and explains that they rub them because, “it just feels good” or, “it’s relieving.”  They tend to use their palm or back of the hand in a back and forth motion. Or, apply pressure in the corner of their eye with a finger tip.

The keratoconus patient who rubs their eyes may say the do it because, “it helps me see better.” They tend to apply greater pressure on the center of the eyelid, using circular motions with a knuckle or two fingertips pads.

Keratoconus Treatments