Keratconus

Keratoconus is a degenerative disorder of the eye in which structural changes within the cornea cause it to thin and change to a more conical shape than its normal gradual curve.

Mild cases may be corrected with normal spectacles

ALL Newly Diagnosed Cases should be referred to a corneal surgeon for assessment for corneal cross- linking.

Corneal collagen crosslinking with riboflavin, also known as CXL, CCL, C3-R and KXL, involves a one-time application of riboflavin solution to the eye that is activated by illumination with UV-A light for approximately 30 minutes. The riboflavin causes new bonds to form across adjacent collagen strands in the stromal layer of the cornea, which recovers and preserves some of the cornea’s mechanical strength. The corneal epithelial layer is generally removed to increase penetration of the riboflavin into the stroma.

In most cases, corrective rigid contact lenses fitted by a specialist contact lens fitter are effective enough to allow the patient to continue to drive legally and likewise function normally. Further progression of the disease may require surgery, for which several options are available, including intrastromal corneal ring segments, cross-linking, mini asymmetric radial keratotomy and, in 25% of cases, corneal transplantation.

Keratoconus has been associated with atopic diseases, which include asthma, allergies, and eczema, and it is not uncommon for several or all of these diseases to affect one person. ( It affects the embryonic ectodermal Tissue) Keratoconus is also associated with Down syndrome and Marfan syndrome.

In keratoconic patients, rigid contact lenses improve vision by means of tear fluid filling the gap between the irregular corneal surface and the smooth regular inner surface of the lens, thereby creating the effect of a smoother cornea. Some trial-and-error fitting may prove necessary.

Some patients also find good vision correction and comfort with a “piggyback” lens combination, in which RGP lenses are worn over soft lenses, both providing a degree of vision correction. One form of piggyback lens makes use of a soft lens with a countersunk central area to accept the rigid lens. Fitting a piggyback lens combination requires experience on the part of the lens fitter, and tolerance on the part of the keratoconic patient.

Duette HD contact lenses with a rigid centre and soft skirt are working well for moderate degrees of keratoconus.

Scleral lenses are sometimes prescribed for cases of advanced or very irregular keratoconus; these lenses cover a greater proportion of the surface of the eye and hence can offer improved stability.

Between 11% and 27% of cases of keratoconus will progress to a point where vision correction is no longer possible, thinning of the cornea becomes excessive, or scarring as a result of contact lens wear causes problems of its own, and a corneal transplantation or penetrating keratoplasty becomes required.

The acute recovery period can take four to six weeks, and full postoperative vision stabilization often takes a year or more, but most transplants are very stable in the long term.

Here Are Video’s covering Cross linking, Contact Lenses and Corneal GraftBgBYAMfDq60