Keratoconus, or KC, is a sight-threatening eye disease in which the typically round, dome-shaped cornea progressively thins and weakens, causing the development of a cone-like bulge and blurry or distorted vision.
In the early stages of keratoconus, people might experience:
• Mildly blurred vision
• Frequent prescription changes
• Excessive eye rubbing
• Difficulty seeing at night
• Frequent headaches
• Vision that cannot be fully corrected with glasses or contact lenses
The cornea is responsible for focusing most of the light that comes into the eye. Therefore, abnormalities of the cornea, such as keratoconus, can have a major impact on how an individual sees the world, making simple tasks such as driving a car or reading a book very difficult. KC can result in significant visual loss and may lead to a corneal transplant if left untreated.
Approximately 10% of people with KC have affected relatives
Affects all ethnicities & both genders
An estimated 5-30% of people with Down syndrome are also affected by keratoconus
Typically first diagnosed in young people at puberty or in their late teens, but can affect older adults too
Younger age at onset
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Keratoconus involves both genetic and environmental factors.
Many genes have been identified that increase the risk for keratoconus. Genetic testing to determine your risk of the disease will be available at the Bay Area Eye Institute in early 2021.
Eye rubbing is usually associated with atopic conditions like asthma, hay fever, eczema, 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.
If keratoconus continues to progress, treatment intervention is needed to slow or halt the progression of the disease and preserve vision. Corneal cross-linking is a minimally invasive outpatient procedure that combines the use of ultra-violet (UV) light and riboflavin (vitamin B2) eye drops. Cross-linking stiffens and strengthens the collagen fibers of the cornea that have been weakened by keratoconus. It may also help KC from getting worse over time.
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 is a hallmark sign of both allergies AND keratoconus. All eye rubbing is not the same and tends to have different patterns, depending on whether allergies or keratoconus is the cause. Check this out:
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 they 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 fingertip pads.