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Keratoconus – What is it?

Keratoconus is a non-inflammatory ectasia or protrusion of the cornea. It is characterized by progressive thinning and steepening of the central cornea. As the cornea steepens and thins, the patient experiences a decrease in vision which can be mild or severe depending on the amount of corneal tissue affected. The onset of keratoconus usually starts in the teenage years or early 20s. It rarely develops after the age of 35. Keratoconus shows no gender predilection and is bilateral in over 90% of cases. In general, the disease develops asymmetrically. Diagnosis of the disease in the second eye usually lags 6 or 7 years after diagnosis in the first.

The incidence of keratoconus is about 2 to 3 people per 1000 population.

As the condition progresses, the distorted cornea will require a contact lens, usually rigid gas permeable. The progression of keratoconus is unpredictable. While keratoconus interferes with the clarity of a persons sight, it rarely causes blindness. With the latest contact lenses specifically designed for keratoconus, the need for a corneal transplant has been significantly reduced.

What Causes Keratoconus?

 

The characteristics of keratoconus have been known for at least 200 years, but the specific causes are still undetermined. Several theories have been proposed. One theory is that keratoconus is genetic in origin but only about 7-15% of patients have other family members with the disease. Another view holds that keratoconus is secondary to some disease process. While there are many theories, research into keratoconus continues.

 

Dr. Erika Morrow completed her Master’s Degree in Vision Science concurrently with her Doctorate of Optometry. Dr. Morrow researched Keratoconus and atopic disease (chronic allergy condition) and the research suggested that those that have keratoconus also have chronic allergy symptoms including sneezing, tearing, and itchy eyes. There is a strong correlation between those that have keratoconus and rub their eyes. It is very common that someone with keratoconus will admit to rubbing their eyes often and the disease is worse in the eye on the side of their dominant hand. For instance, the condition is often worse in the right eye, if the patient is right handed. Eye rubbing causes the cornea to become weak and it begins to get thin and steepens, resulting in keratoconus.

 

Every patient with keratoconus should do everything they can to limit all eye rubbing. Dr. Morrow recommends using cold compresses when the eyes feel itchy, keep the eyes hydrated with a branded moisture drop (Optase Intense Drops is Dr. Morrow’s favorite), and to use Pataday Extra Strength every morning in each eye. It is very important to stop rubbing your eyes to prevent progression of the condition.

 

Another condition that is often present in those with keratoconus is sleep apnea. Many patients that have keratoconus admit to snoring at night. Dr. Morrow refers all patients that know they snore to a local Ear, Nose, and Throat specialist for evaluation and treatment.

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