Keratoconus

What is Keratoconus?

Keratoconus is a degenerative eye disorder affecting the cornea. It occurs in 1:2000 people often occurring in adolescence. Initial symptoms of irregular, mild astigmatism that can be corrected by the use of glasses or contact lenses can give way to increased levels of astigmatism that cannot be fully corrected.  

The problem is often bilateral (in both eyes) and those with a family history of keratoconus have a greater disposition to the problem as do those with atopic ailments such as asthma, allergies and eczema and down syndrome. 

In circumstances where vision has declined and cannot be corrected with glasses or contact lenses a number of surgical procedures may be available. These options involve implants that re-shape the cornea or surgery to partially or wholly replace the cornea (corneal grafting techniques).

The reason it occurs is not entirely known, it has however been linked to detrimental enzyme activity within the cornea and early treatment with a relatively new treatment called corneal collagen cross-linking has been shown to stabilize the onset and effectively prevent worsening of the condition. If treated early the aim would be to halt the progress of this debilitating disease and minimize the need for future surgery

Corneal Collagen Cross-Linking Treatment

An assessment is needed to ensure there are no underlying issues that might prohibit a successful outcome.  The single treatment is carried out in outpatients using a topical anaesthetic (drops) and involves periodically applying a measured solution of riboflavin to the cornea every 3-5 minutes over a 30 minute period followed by the application of UVA light, again over 30 minutes.  To enable penetration of the cornea and a better result, surface tissue is removed at the beginning of the procedure in much the same way as a LASEK procedure.

 

The procedure has been shown to greatly improve the integrity of the cornea, reducing the degenerative process. 

The procedure is not painful. Some discomfort will be felt after the procedure when the anaesthetic wears off and may last for a few days whilst the corneal surface heals. Professor Aggarwal uses a technique that results in maximum absorption of the active solution with minimal surface tissue removal. This reduces the level of discomfort following the procedure.

Professor Rajesh Aggarwal

BM MRCP FRCS FRCOphth Pg.Cert Med.Ed

Consultant Ophthalmologist