As a degenerative condition that affects the structure of the eye, I usually see keratoconus patients in their teens, although that can differ.
Often, because the initial signs are a vague blurriness, patients don’t decide to visit an optometrist until it significantly impacts on their day-to-day life. (Another example of why it’s important to act immediately when you think something’s not right).
Because keratoconus results in the thinning of the cornea, the shape of the eye bulges into a cone shape (rather than the usual spherical shape). This causes visual distortions, which gradually increase as the disease progresses.
Most people know what a cataract is – the lens of the eye hardens and opacifies, mainly with age, but occasionally it can be genetic (children can be born with cataracts), or occasionally it can occur as the result of an eye trauma.
Fortunately, there’s a wide range of treatments available for keratoconus. If diagnosed in its initial stage, I would most likely prescribe the patient a corrective contact lens specifically for their needs. This is often all that is needed to ensure they can attain the legal driving standard.
As it progresses, keratoconus treatments may include the surgical insertion of intra corneal ring segments to push out against the bulging of the cornea. I mainly use Intacs for this procedure, and in fact was the first surgeon in Australia to do so.
A newer treatment is collagen cross-linking. This uses collagen combined with riboflavin to strengthen the cornea.
I will recommend a corneal transplant only when it becomes absolutely necessary.
I lead a basic science research team which is looking at avenues to develop new treatments modalities to prevent keratoconus progression.
My book on the findings, ‘A Users Manual for People with Keratoconus’, has just been released. Click here to purchase a copy of the book – (all royalties will be donated directly to the Sydney Eye Hospital Foundation; Keratoconus Research Fund).