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Keratoconus is a disorder affecting the front window of the eye known as the cornea. The cornea thins which results in an irregular cone shape, distorting vision making it difficult to correct the focus with normal glasses. It often affects both eyes one more so than the other. Keratoconus onset is normally in the teenage years, worsened by vigorous eye rubbing and allergic eye conditions. Keratoconus is fairly common in New Zealand compared to other regions around the world.
The cause of keratoconus is at this stage largely unknown. It is believed to have a genetic component as it does commonly run in families. Vigorous prolonged eye rubbing is associated with keratoconus progression. Many patients often have other allergic conditions like eczema, food or seasonal allergies.
As keratoconus progresses glasses are less effective at improving vision loss.
Specialised contact lens fitting
In the milder form of Keratoconus, soft contact lenses or glasses can often provide adequate vision for the patient. As the condition advances and the cornea becomes more distorted, specially designed soft lenses are often needed. In advanced cases rigid gas permeable contact lenses are often the best option for vision correction.
A contact lens for Keratoconus is created with a spherical frontal curve to provide clear vision for the patient while the back of the curve is a tailored fit so the lens can remain fixed on the unusually shaped cornea.
The process of fitting a contact lens for keratoconus is subtle and can take a bit of time. To set expectations, there are often return visits to the optometrist to fine-tune the fit and the prescription - in some cases it can take several months. In addition, the lenses will need to be revised and refitted regularly to ensure the patient can maintain good healthy corneas to allow good vision and maximise the level of comfort for the patient.
A poor fitting contact lens can cause discomfort, poor vision and potentially even cause scarring on the surface of the eye.
The New Zealand Ministry of Health provides a small subsidy for lenses and fitting for some keratoconus patients so please ask your Optometrist for more information.
Corneal cross-linking
If your keratoconus is rapidly progressing then a procedure called corneal crosslinking is available. This works by stiffening the cornea to minimise progression. This cross-linking procedure is not a cure for Keratoconus and does not reverse any change that has already occurred. It is aimed at halting or slowing the progression and therefore stopping further loss of vision or the need for a corneal transplant.
Corneal Intacts
These are semi-circular plastic rings which are implanted into the cornea. They work by stretching the central cornea, causing it to flatten and reducing vision distortion. They are usually more useful in milder forms of Keratoconus and are able to be removed should the condition advance.
Corneal Graft
Should Keratoconus progress to where contact lenses are no longer an option then a corneal graft may be recommended. While there is some risk of tissue rejection, these transplants do have a fairly high rate of success.
It is likely that Glasses or Contact lenses will still be required after 'the 'Cross Linking' treatment, Intacts, or Corneal Graft because your prescription will change.
Kiwi's know that good things take time, so come to us, have the tests done without feeling that you have been "rushed thru", and you'll know what we mean when we say "we take the time!"
Book appointmentKiwi's know that good things take time, so come to us, have the tests done without feeling that you have been "rushed thru", and you'll know what we mean when we say "we take the time!"
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