Keratoconus is a terrifying diagnosis to those that have experienced it. To compound issues, many patients complain that they had poor initial treatment due to a lack of understanding about the disease. If proper treatment is not achieved, individuals may experience a rapid deterioration in their ability to see. This leads to a reduced quality of life. You can reduce the stress related to a keratoconus diagnosis and increase the benefits of treatment by understanding your treatment options.

Understanding Keratoconus

Keratoconus is an eye disease that causes the cornea to thin and bulge. This bulge generally takes on the appearance of a cone. As light enters the eye, it becomes distorted by the cone causing vision abnormalities.

Risk Factors

No one knows what causes keratoconus, although genetic and environmental factors are thought to be involved. Around 1 in 10 people with keratoconus also have a parent with the condition.  Certain risk factors can increase your chances of developing keratoconus:

• Having a family history of keratoconus
• Rubbing your eyes vigorously
• Having certain conditions, such as retinitis pigmentosa, Down syndrome, Ehlers-Danlos syndrome and asthma
• chronic eye irritation and allergies
• UV damage

Treatment Options

While your eye professional will have the best understanding of what treatment option is right for you, here are some of the most common treatments:

• Corneal Cross-linking (CXL) – There are two different types of this procedure, but they both introduce riboflavin to the cornea in order to strengthen the corneal tissue and stop the bulging from progressing.

• Custom Soft Contact Lenses – Soft contacts are generally more comfortable to wear than gas permeable lenses. Recently, some contact companies have been able to create a contact specifically to correct the issues related to mild cases of keratoconus.

• Intacs – These implants are surgically placed in the eye. They are small plastic inserts that are inserted into the cornea to smooth the surface shape. This option is also designed for patients who could not use other contact lens types and often makes wearing soft contact lenses possible.

• Gas Permeable Contact Lenses – Gas permeable lenses are a hard contact lens that physically forces the eye to adhere to the lens shape. This allows for the correction of keratoconus. The fit is often time-consuming and may take several different lenses to achieve the proper fit.

• Piggybacking Contact Lenses – This method is used for individuals who require a gas permeable lens but cannot tolerate wearing rigid contacts. Piggybacking utilizes a soft lens placed on the eye first, and then a gas permeable lens is placed over the top. This offers the comfort of soft contacts with the rigidity and clarity of the gas permeable lenses.

• Hybrid Contact Lenses – Hybrid contact lenses were designed specifically for keratoconus. This technology blends a rigid contact lens center with a softer edge, or skirt, of the contact.

• Scleral and Semi-Scleral lenses – These lenses are gas permeable lenses but cover a larger area of the eye than a standard rigid lens. These lenses don’t put pressure onto the cone shape of the eye. The reduced pressure results in a more comfortable fit for patients.

• Topography-Guided Conductive Keratoplasty – This treatment option is still being researched, but it uses the energy from radio waves and small probes to map the surface of the eye. This detailed mapping allows for an appropriate treatment plan for the patient.

• Corneal Transplant – Patients with advanced keratoconus may no longer be able to tolerate a contact lens, or the different lens types may not be correcting the issues. This surgery removes the damaged cornea and replaces it with a healthy cornea.

• Prosthetic Lenses – This lens is used specifically for patients that have very advanced keratoconus and have ruled out other options. The advanced scleral lens also doubles as a protective prosthetic shell. There are special requirements to qualify for this lens.

There is hope for individuals with keratoconus. Even though the disease is degenerative, many patients report restored vision and improved quality of life when the appropriate treatment plan is in place. If you have been diagnosed with keratoconus or are having problems with your vision, seek a consultation with Dr. Kubota to determine the best line of treatment.