What Is Keratoconus?
What is Keratoconus? Keratoconus is one of the corneal ectactic eye disorders that causes thinning and irregularities on our Cornea.
In a healthy eye, the cornea is able to keep a shape like that of an American football. What helps the cornea to keep its proper shape? Tiny fibres of protein in our eyes called collagen help hold our corneas shape, sort of like a mesh.
Those of use that suffer from Keratoconus tend to have very weak fibres. Our eyes can’t hold the football shape and the cornea instead begins to distort into more of a cone shape than a football and that’s when our vision begins to deteriorate.
Our vision is greatly impacted by this distortion in our cornea. Once the light enters our irregular cornea the light is unfocused, so our brain gets a false impression of what we are seeing, and the result is a completely smeared view of the world.
This happens since when we don’t have enough protective antioxidants in your cornea. Cells produce harmful by products (free radicals), sort of the same way a car puts out exhaust.
Normally, antioxidants get rid of these free radicals and protect the collagen fibres. In our case though our antioxidant levels are to low to clear out the free radicals, thus collagen weakens and the cornea bulges.
Trying to explain what Keratoconus is to family and friends can be difficult. So, in simple terms, ‘Keratoconus is a degenerative eye disorder that causes thinning and irregularities on our cornea’
Keratoconus Timeline
Early Stage
For many of us, we will most probably get diagnosed in our mid teens which is most common, however, it can begin in earlier childhood, as well as in our 30’s.
It can also begin in some of us in our 40’s and older but this scenario is quite rare.
KC(Keratoconus) is a progressive eye disorder so unfortunately the distortion in our corneas and our vision will get worse over time.
The rate of the progression in many cases as with me will be different in each eye. In my right eye for example, the rate of progression was much more aggressive then in my left eye.
In general, the progression is more aggressive in the early stages. The most rapid change will come in those of us aged 15-20 and usually stabilizes (stops progressing) by age 40-45.
For some though, it can stop much earlier, and others might experience some progression in their 50’s.
In these early stages, our vision has not yet begun to suffer to much if at all. The distortion of our cornea at this stage is minimal.
If our sight is slightly compromised at this stage spectacles or contact lenses can usually correct our vision for a while. We could be a candidate for cross-linking as well, depending on how earlier we are diagnosed.
Intermediate Stage
Corneal distortion increases. At this point if we are using spectacles to help our vision, we might need to change our prescription.
If our spectacles prescription deteriorates by more than one diopter in sphere (near or far sightedness) or cylinder (astigmatism) in one year, it’s safe to say we have Keratoconus and could be headed to being contact lens intolerant, depending on the type of lenses.
If we have reached the point where spectacles no longer help us to perform our daily activities outside of our home, our optometrist at this point will refer us to an ophthalmologist.
At this stage, in terms of non-invasive procedures, larger diameter contact lenses such as sclerals become a better option.
Advanced
In this stage, our cornea has distorted to steeper degree. Now even some lenses are no longer an option due to the severe cone shape of our cornea, making it near impossible for our eyes to hold some lenses.
Scleral lenses, which I use at the present moment, are now a good option because of their larger diameter allowing the lens to vault over the cornea rather than resting on it.
There are other options at this stage such as mentioned earlier cross-linking, intra-stromal corneal ring segment, Photorefractive keratectomy (PKR), intra ocular lenses or a combination of all the above-mentioned treatments, again depending the aggressiveness of keratoconus.
Will we go Blind?
We won’t go blind from KC but if left untreated, performing normal every tasks will become increasingly more difficult and for many of us quality of life could very well be diminished.
Getting a diagnosis as early as possible is our best weapon, to this point against Keratoconus.
Without treatment or without the help of spectacles, contacts lenses, our vision won’t get better and in almost all cases it will get increasingly worse.
At the moment there is no cure, so early detection, management and education are paramount in the fight against Keratoconus.