What is keratoconus?

Keratoconus is the most common degenerative change which occurs in the cornea, characterized by non-inflammatory progressive thinning of the cornea, which acquires a conical shape. It affects about one person in two thousand inhabitants, and it’s more often encountered in men than in women. It occurs in all populations around the world, although it occurs more frequently in certain ethnic groups.

The exact cause of keratoconus is still unknown, but is thought to be associated with poor enzyme activity within the cornea. A genetic predisposition has aslo been established. The progression of keratoconus is rapid in patients with Down syndrome. It is believed that the disease usually affects both eyes, but usually one eye has a more pronounced disease progression. Usually the most progress is seen in adolescence and then it stabilizes (though this is not a rule). 

What are the symptoms?

The most common occurrence is the unilateral decline in visual acuity due to progressive myopia and astigmatism, which becomes irregular. The main symptoms are: central and paracentral thinning of the corneal stroma (which acquired a conical shape).  

Methods of treatment:

Treatment of mild to moderate keratoconus is wearing of spectacles and semi-hard or hard contact lenses and regular monitoring of disease progression. For progressive forms of the disease patients are advised to undertake the cross linking method. Patients who tolerate lenses are often satisfied with their vision. Patients with advanced stages of keratoconus, those patients who can not wear lenses or their visual acuity declines to below 30%, and patients with significant thinning of the cornea are candidates for corneal transplantation. If there is a corneal decompensation and cornea has irretrievably lost its transparency, than perforative corneal transplantation is the only method to treat these patients. The best techniques that are used for diagnostics and monitoring of the course of the disease are OCT-optical coherence tomography of the front part of the eye and Pentacam- computerized corneal topography.