More than 93% of keratoconus patients can stop the disease from getting worse with corneal cross-linking. This treatment makes the cornea stable and might avoid the need for a cornea transplant later. This shows big steps forward in treating this eye condition, which can really affect how well you see and focus.
In this article, we look at the newest treatments in the UK. These options help people with keratoconus see clearer and sharper.
Key Takeaways
- Corneal cross-linking is a highly effective treatment that can stabilise the cornea and prevent the need for a cornea transplant in over 93% of keratoconus patients.
- Intrastromal corneal ring segments (ICRS) and cornea transplants are surgical options for treating keratoconus.
- Specialised contact lenses, such as rigid gas permeable, piggyback, hybrid, and scleral lenses, can effectively manage vision in advanced keratoconus cases.
- Early detection and treatment are crucial to halt the progression of keratoconus, as the condition typically develops in teenagers and young adults.
- A combination of corneal reshaping and collagen cross-linking can correct visual irregularities caused by keratoconus in 80 to 95% of patients.
Understanding Keratoconus
Keratoconus is a condition that affects the cornea, the clear front of the eye. It makes the cornea thin and change shape, becoming conical. This can cause vision problems like short-sightedness and irregular astigmatism, affecting daily life.
What is Keratoconus?
Keratoconus makes the cornea thin and bulge. This stops it from focusing light properly, causing blurry vision. In severe cases, scarring can block more light, worsening vision.
Causes and Risk Factors
The exact cause of keratoconus is still unknown. It’s thought to be a mix of genetics and environment. Some ethnic groups are more likely to get it, suggesting a genetic link. Eye rubbing and certain eye conditions may also play a role.
About 1 in 10 people with keratoconus have a family history of it. It usually starts in late teens to early 20s. Symptoms can progress for 10 to 20 years.
“Keratoconus often starts affecting individuals in their late teens to early 20s, with the progression of symptoms spanning a period of about 10 to 20 years.”
Early detection and treatment are key for keratoconus. It can greatly affect vision and daily life if not treated. Knowing about keratoconus is the first step to finding the right treatment for better vision.
Early Detection and Diagnosis
Keratoconus is a progressive eye condition that often starts in teenagers and young adults. It’s important to catch it early to manage it well. People with keratoconus may have trouble focusing and see blurry, with vision getting worse over time. Getting medical help quickly is key to slowing down the disease.
Worldwide, about 1.38 per 1,000 people have keratoconus. It’s more common in South Asians and Middle Easterners than in Europeans. People with keratoconus often notice their vision is blurry, distorted, and keeps changing.
Only 8% to 10% of those with keratoconus have family members with it. It usually starts in the early twenties and gets a bit worse before it stops. It’s linked to conditions like Down syndrome and Marfan syndrome.
Spotting keratoconus early is vital. Corneal cross-linking (CXL) treatment works for over 90% of patients in just one 30-minute session. Faster CXL treatments are also available at Moorfields Eye Hospital. People in their thirties with keratoconus need check-ups every six months, and those at higher risk should go every three months.
| Keratoconus Diagnosis | Keratoconus Symptoms | Keratoconus Progression |
|---|---|---|
| The Amsler-Krumeich scale is the most commonly used grading system for KC. | Patients may experience blurring, distorted vision, and frequent changes in spectacle prescriptions. | KC typically progresses asymmetrically and ceases in most patients by the fourth decade. |
| Morphologically, KC is differentiated into three types of cones: small, isolated, round cones; ellipsoid oval cones; and large globus cones. | Only 8% to 10% of KC patients have a family history of the disease. | Onset of KC typically occurs around the second decade of life, with the disease progressing slowly thereafter. |
Spotting keratoconus early is key to managing it well. It lets doctors act fast and use the right treatments. This helps stop the disease from getting worse and keeps vision good.
Keratoconus Treatment Options
Keratoconus is a progressive eye condition that can’t be treated with eye drops or medication alone. But, there are several effective treatments to manage it and improve vision. Corneal Cross-Linking and Intacs (Corneal Rings) are two common procedures used.
Corneal Cross-Linking
Corneal Cross-Linking is a well-accepted treatment that can stop keratoconus from getting worse in over 93% of patients. It uses riboflavin eye drops and ultraviolet (UV-A) light. This makes the corneal fibres stronger and stiffer, stabilising the cornea and preventing further distortion.
Intacs (Corneal Rings)
Intacs, or intracorneal stromal ring segments, are a surgical option to improve the cornea’s shape and reduce irregularity. This procedure, which takes about 15 minutes, involves putting plastic rings into the cornea. It flattens the cornea’s surface and helps with light refraction.
These treatments, along with other advanced therapies, can greatly improve vision and quality of life for those with keratoconus. Corneal Cross-Linking and Intacs address the structural issues. They offer effective solutions to stop keratoconus from progressing and restore clearer vision.
| Treatment Option | Description | Procedure Time | Success Rate |
|---|---|---|---|
| Corneal Cross-Linking | Uses riboflavin and UV-A light to strengthen the cornea | Approximately 1 hour | Over 93% of patients |
| Intacs (Corneal Rings) | Inserts plastic rings into the cornea to improve its shape | Approximately 15 minutes | Varies based on individual case |
Advanced Keratoconus Treatments
For those with advanced keratoconus, new treatments can help. Transepithelial Phototherapeutic Keratectomy (TransPTK) and Phakic Intraocular Lens Implants are showing great promise. They aim to improve vision and stop the cornea from getting worse.
Transepithelial Phototherapeutic Keratectomy (TransPTK)
TransPTK uses laser to gently flatten the cornea. It helps those wearing glasses or contact lenses see better. It’s often paired with corneal cross-linking to keep the cornea stable.
This method keeps the top layer of the cornea intact. This means less discomfort and quicker healing for the patient.
Phakic Intraocular Lens Implants
Phakic ICLs are for those with good vision in glasses or soft contacts. These lenses sit inside the eye, in front of the natural lens. They correct vision and reduce the need for glasses or contacts.
ICLs are a good choice for those wanting to avoid reshaping the cornea. This is different from other keratoconus treatments.
| Treatment | Description | Advantages |
|---|---|---|
| TransPTK | Surface laser treatment to flatten and smooth the cornea |
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| Phakic Intraocular Lens Implants | Specialised lenses placed inside the eye to correct refractive errors |
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“These advanced treatments for keratoconus offer patients new hope for clearer vision and improved quality of life.”
Corneal Transplant
In advanced keratoconus cases, a corneal transplant is often the last option. This surgery replaces the cornea with a donated one. It’s usually considered after other treatments fail.
There are different types of corneal transplants, like PK, DALK, and EK. Most transplants work well, but risks like rejection and infection can happen. They can last for over 10 years without problems.
Recovery times vary, with full-thickness transplants taking about 18 months. DALK and EK might heal faster. The UK faces a shortage of donated corneas, limiting transplant availability. Registering as an organ donor can help increase cornea supply.
| Surgical Technique | Recovery Time | Rejection Risk |
|---|---|---|
| Penetrating Keratoplasty (PK) | 18 months | Higher |
| Deep Anterior Lamellar Keratoplasty (DALK) | Faster | Lower |
| Endothelial Keratoplasty (EK) | Faster | Lower |
Corneal transplantation is the last resort for advanced keratoconus. It’s used when other treatments fail. Keratoconus is a common reason for this surgery, making up about 25% of cases.
About 80% of patients see better within a year after surgery. The success rate is high, with most transplants staying clear for 5 years. Yet, about 5% might need another surgery.
“Corneal transplantation becomes the last resort for advanced keratoconus cases when other treatments are no longer effective.”
Keratoconus Treatment
Keratoconus is a condition that can’t be cured but can be managed. There are many treatments to help improve vision. The right treatment depends on the condition’s stage and how severe it is. Early treatment is key to stop the cornea from getting worse and keep vision good.
In the early stages of keratoconus, glasses or soft contact lenses can correct vision. Harder contact lenses are needed as the condition gets worse. Corneal crosslinking treatment uses UV light to slow the condition’s progression.
For more severe cases, implantable ring segments (INTACS) can be used. These are inserted into the cornea to improve vision. In very advanced cases, a cornea transplant might be needed. This can improve vision but may take over a year to stabilise.
Each treatment has its own risks, such as eye pain, dry eyes, or infection. INTACS can cause glare or halo issues and thinning of the cornea. Cornea transplant risks include graft rejection, infection, and glaucoma.
The time it takes to recover from these treatments varies. Some treatments need only a few days, while others take longer. Choosing the right Keratoconus Treatment Options and Keratoconus Management depends on individual needs and the eye care professional’s expertise.
| Treatment Option | Description | Potential Complications | Recovery Time |
|---|---|---|---|
| Corneal Crosslinking | Exposing the eye to UV light to slow or stop disease progression | Eye pain, dry eyes, worsening of keratoconus, infection | Few days |
| INTACS (Corneal Rings) | Implantable plastic rings to improve vision and aid contact lens fitting | Infections, glare or halo issues, corneal thinning | Varies |
| Corneal Transplant | Replacing the cornea with a donor cornea for advanced keratoconus | Graft rejection, infection, glaucoma | Over a year for vision stabilisation |
“Early intervention is crucial to prevent further deterioration of the cornea and maintain good visual quality.”
Vision Management with Lenses
Rigid Gas Permeable Lenses
For those with keratoconus, special contact lenses can help manage vision. Rigid gas permeable (RGP) lenses are one such option. They can correct the cornea’s irregular shape and improve vision.
In some cases, when other treatments fail, RGP lenses are key. They fit the keratoconic cornea, offering clear vision. These lenses are made to let oxygen reach the cornea, keeping it healthy.
Unlike soft lenses, RGP lenses don’t change shape to fit the cornea. Instead, they create a new surface for vision. This helps hide the cornea’s irregular shape.
Studies have shown RGP lenses are effective in treating keratoconus. A 2003 study in the American Journal of Ophthalmology found them to be part of a successful treatment. This included riboflavin/ultraviolet-A-induced collagen crosslinking.
While adjusting to RGP lenses can take time, their long-term benefits are clear. They offer a stable and clear vision, improving life quality for those with keratoconus.
Prevention and Lifestyle Adjustments
The exact cause of keratoconus is still unknown. However, some lifestyle factors might make it worse. Excessive eye rubbing is a big no-no. It can make the cornea thinner and more deformed. People with keratoconus should avoid rubbing their eyes to prevent worsening symptoms.
Good eye health and hygiene practices are also important. Regular eye exams and wearing sunglasses for UV protection are key. A healthy lifestyle, including a balanced diet and exercise, can also help.
- Keratoconus usually starts in late teens or early twenties.
- Regular check-ups with eye specialists are vital to track the condition.
- Eating foods rich in antioxidants, like fruits and veggies, can protect your eyes.
While keratoconus can get worse, the right management and lifestyle changes can help. These steps can preserve your vision and improve your quality of life.
“Early detection and proactive management are key to maintaining vision health in individuals with keratoconus.”
Surgical vs Non-Surgical Approaches
Keratoconus treatment often mixes surgery and non-surgery, based on the patient’s needs and the disease’s stage. Non-surgical methods are usually the first choice. But, severe cases might need surgery to fix the cornea and improve sight.
Non-Surgical Keratoconus Treatments
Most keratoconus patients start with non-surgical treatments. These can stop the disease from getting worse and help their vision. The main non-surgical treatments are:
- Corneal Cross-Linking, which makes the cornea stronger and slows keratoconus.
- Scleral lenses, which give clear vision by covering the irregular cornea.
- Gas Permeable (RGP) lenses, used for years but can be uncomfortable.
- Hybrid lenses, which mix a gas-permeable core with a soft skirt, offering better comfort but sometimes less clear vision.
- Soft lenses, the least used non-surgical option because they don’t fit well and don’t correct vision well.
Surgical Keratoconus Treatments
When non-surgical methods fail, surgery might be needed. The main surgeries are:
- Intracorneal Ring Segments (Intacs), which flatten the cornea to improve vision.
- Transepithelial Phototherapeutic Keratectomy (TransPTK), a laser treatment to reshape the cornea.
- Corneal Transplant (Penetrating Keratoplasty or DALK), a last resort to replace the damaged cornea with a healthy one.
Choosing between surgery and non-surgery depends on the disease’s severity and the patient’s needs. It’s crucial to work closely with an experienced eye doctor to manage keratoconus effectively.
When to Seek Treatment
Keratoconus often starts in teenagers and young adults. It’s important to catch it early. If you have trouble focusing or notice changes in your cornea, see an eye doctor.
Keratoconus symptoms can get worse over time. You might see blurry vision, have trouble with contact lenses, or notice your vision changing. In severe cases, the cornea can swell and scar, making vision even worse.
An eye doctor can spot keratoconus during a routine check-up. They’ll look at your cornea and check its shape. Catching it early means you can start treatment sooner, like wearing glasses or getting special contact lenses.
Keratoconus often affects both eyes differently. It’s also important not to rub your eyes, as it can make the condition worse. Rubbing can damage the cornea and thin the tissue.
| Keratoconus Diagnosis | Keratoconus Symptoms | Keratoconus Treatment Timing |
|---|---|---|
| Routine eye exam, corneal examination, and curvature measurement | Blurry and distorted vision, increased nearsightedness or astigmatism, discomfort with contact lenses | Early detection and intervention are crucial to halt the progression of the disease and prevent further deterioration of vision |
If your vision or eye health changes, get help right away. Catching keratoconus early can save your vision and improve your life.
Conclusion
Keratoconus is a complex eye condition that needs quick and effective treatment. This is to keep vision and quality of life good. Understanding the Keratoconus Treatment Summary options helps patients and doctors create a plan. This plan meets the patient’s specific needs.
Early detection and a proactive treatment approach are key. They help keep vision clear and stable. This improves the well-being of those with keratoconus.
New studies show promising results for keratoconus treatments. For example, intrastromal corneal ring segments (ICRS) and femtosecond laser technology in surgeries. These advancements lead to better vision, fewer complications, and more comfort for patients.
Specialised contact lenses, like rigid gas-permeable (RGP) and scleral lenses, also help. They offer effective solutions for different keratoconus stages.
Healthcare professionals are dedicated to providing personalised care for keratoconus patients. They keep up with the latest treatments and work closely with patients. This ensures patients get the best therapies for clear vision and a better quality of life.
FAQ
What is keratoconus?
Keratoconus is a condition where the cornea, the clear front of the eye, thins and changes shape. This can make it hard to see clearly and can cause short-sightedness and irregular astigmatism.
What causes keratoconus?
The exact reason for keratoconus is still a mystery. But, it’s believed that genetics and eye rubbing might play a part.
How is keratoconus diagnosed?
Doctors diagnose keratoconus with a detailed eye check. This includes measuring the cornea and doing vision tests.
What are the treatment options for keratoconus?
Treatments for keratoconus include corneal cross-linking and Intacs. Other options are phakic intraocular lens implants and corneal transplantation. The right treatment depends on how severe the condition is.
How does corneal cross-linking work?
Corneal cross-linking uses riboflavin drops and UV-A light. It strengthens the cornea, stopping keratoconus in over 93% of cases.
What is the role of specialised contact lenses in managing keratoconus?
RGP lenses can help keratoconus patients. They correct the cornea’s shape and improve vision.
When should someone with keratoconus seek treatment?
It’s important to catch keratoconus early. If you notice vision problems or changes in your cornea, see an eye doctor right away.
