What is Keratoconus?
It is quite easy to forget just how important our five senses are. We rely on it so much that we have a tendency to take it for granted, Thus, if one of our “senses” has suddenly been cut off, it will just as likely to wreak havoc on the way we live our lives as much as it how it can potentially damage the overall functioning of our bodies. So with that in mind, we will just be as devastated if one of our eyes suddenly started functioning erratically. Think of how disorienting and frustrating that can be. And so, out of all the dozen eye disorders that is known throughout the world, one of the less common is keratoconus.
What is keratoconus exactly? It is a condition of the eye which affects the corneal area. Primarily, it is characterized by a non-inflammatory cone-like protuberance or “bulge” inside the central part of the cornea. Because of that bulge, it causes an unusual and progressive thinning of the affected organ.
It can also cause an irregular astigmatism, another eye condition in which the light rays coming from an outside source cannot be focused clearly in a point on the retina.
Picture of Normal eye and keratoconus (right)
Symptoms of Keratoconus
- As hinted above, the main complication of keratoconus is the development of astigmatism; basically, it is a blurring of the vision, and this also happens to be the most prominent symptom for this type of condition.
- Other signs of keratoconus may also be the scarring of the cornea, which can occur in really serious cases since it has a chance to “displace” the organ.
Causes of Keratoconus
While most researchers still do not know the exact cause of keratoconus, a link has been found between women who have suffered from keratoconus and to those children, whom they have given birth to, who coincidentally, are also females.
When these females reach the age of adolescence, this is where the onset of keratoconus starts. What is worse is that this condition may progress up to 20 years, and be bilateral or affect both eyes of the sufferer. Hence, doctors stress that it is imperative to find a relief or treatment for this condition, since this has the capacity to debilitate the affected individual by limiting the use of his or her eyes.
Treatment for Keratoconus
Contact lens. In most cases, an application of a rigid and gas-permeable contact lens is the first, and almost often, the most recommended way of correcting the irregular astigmatism that has been brought about as a result of keratoconus, and also as a way of correcting and improving vision. This fitted contact lens should be solely indicated by the client’s ophthalmologist. In these past few years, some huge advances in the design and manufacturing of contact lens have almost reduced the need for surgery.
However, if the contact lens correction is no longer effective, or even if the keratoconus of the client has proved to be so severe as to cause corneal scarring, then this is the time when surgery is considered as an available option.
Surgery for Keratoconus
The success rate of ocular surface transplantation using the oral mucosal epithelium tissue which has been derived from the client’s own body is now considered as being a reasonable treatment and is now usually indicated for eye surgeries. However, tissue rejection still remains as a major cause of failure for the surgery.
Some of the more common surgeries have been around for decades. As mentioned above, one of the “standard” surgeries include tissue grafting. Keratoplasty, or the procedure of transplanting or grafting the cornea tissue by replacing the abnormal host tissue with a healthy “donor” tissue, is one of these procedures which has been already done for years and is also commonly indicated for keratoconus even up until now.
How is Keratoplasty Surgery Performed?
Before going ahead with the procedure, several factors are considered for the surgery to go off without a hitch: the condition of the ocular structure (which includes the lid and the inner or outer conjunctiva, to mention some), the tear film function, the adequacy of blinking, and finally, the viability of the donor organ.
- The surgeon then determines the graft size before the procedure, and the right size is “marked” on the surface of the cornea. The surgeon then prepares the donor cornea and the recipient “bed” (the point where the cornea has been damaged), then he or she removes the “diseased” cornea, places the donor cornea on the recipient bed, and then sutures it in place.
- The sutures will then remain for twelve to eighteen months. Some potential complications that the client may have to be aware of is the development of early graft failure, surgical trauma, acute infection, a persistently increasing intraocular pressure (the internal pressure of the eye), and the most dangerous of all, a late graft failure.
- However, don’t expect the results of the keratoplasty be immediately evident: since the surgery has produced a new optical surface, it can take several months before the client can start seeing the natural and true colors of his or her environment.
- The correction of a refractive (the ability of the eye to clearly focus on an object) error that may have resulted from keratoplasty can be easily done with eyeglasses or contact lenses; if the client can then see with the aid of these refractive tools, that will be then the final visual outcome.
- There are also other more sophisticated types of “surgeries”. Phototherapeutic keratectomy (a small , surgical removal in a part of the cornea that does not warrant a full tissue graft), for example, is also used to treat diseased corneal tissues by removing or reducing the “opacity” of the cornea (which is similar with what is being done with a cataract surgery) and also by “smoothing” the outer corneal surface to improve functional vision.
- Some experts agree that a phototherapeutic keratectomy is a much safer and—arguably—more effective alternative to treating keratoconus than a deeply penetrating keratoplasty. However, just like any surgery, a phototherapeutic keratectomy has also some unwanted side effects.
- Some of these may include hyperopia, a condition in which the eye is unable to focus or see clearly on nearby objects or what most folks call as “farsightedness”, and stromal haze, in which the client may experience having a blurry vision but only because the tear duct of the affected eye has been damaged in some way.
- Some related complications may also develop, like a delay in re-epithelialization or the regrowth of normal tissues over the wounded organ, or even bacterial keratitis, or a generalized inflammation of the cornea caused by an invading pathogen.
- Immediately after a phototherapeutic keratectomy, the care for the client should include the usage of oral analgesics for eye pain, since it can really be discomforting even though the procedure has only involved a minimal extraction of the eye. The tissue growth in the eye is promoted with a pressure patch or the application of a therapeutic “soft” contact lens.
- Antibiotic and corticosteroid ointments and other non-steroidal anti-inflammatory agents like paracetamol are also supposed to be prescribed by the doctor in charge of the client.