Depending on ethnic background, more common in non-whites & is usually diagnosed in young age group at puberty (late teens or early twenties).

Though exact cause is unknown, genetics and environmental factors play a role.

Vision is usually not affected in the very early stages. Further changes in shape, thinning of cornea occursif left unchecked. In advanced stages, scarring causes loss of corneal transparency which impairs the eye’s focusingability. So it is important to detect keratoconus& undergo treatment to avoid vision-threatening complications.

Treatments for keratoconus

• In the early stages: spectacles or soft contact lenses may be used to correct vision.
• Soft or Rigid gas permeable (RGP) contact lenses often prescribed as the cornea becomes thinner and steeper.

Collagen cross linking (CXL)

It is a relatively new treatment that can stop the progression of disease. It is effective in over 94% of patients. Cornea cross-linking is a powerful procedure that can strengthen the weakened collagen fibers of the cornea (which is the cause of keratoconus) and stop it from getting worse.

INTACS

Intacs are very small clear plastic arcs that are designed to be inserted into the substance of the cornea in people who have keratoconus and who can no longer see properly with glasses or contact lenses. Intacs were approved by the FDA for treatment as an alternative to corneal transplant, which used to be a standard treatment for keratoconus prior to Intacs and cross-linking. When they are inserted into the eye, Intacs reshape the cornea by flattening it closer to its original dome shape. Although the procedure usually improves uncorrected vision, the patient will often still need glasses or contact lenses after the Intacs are inserted. After the cornea has been reshaped, patients who were once unable to tolerate contact lenses may be able to return to contact lens wear and see even better than they did with the lenses prior to surgery. Some patients may even be able to see well enough to go back to simply wearing glasses.

Keratoplasty (DALK)

Advanced cases when contact lenses fail to improve vision, a corneal transplant may be needed though this type of intervention is rarely needed since the introduction of corneal cross-linking (CXL).

Diagnosis

The following tests areperformed :

• Vision test (reading chart)
• Refraction test (spectacle test)
• Corneal scans (Pentacam)