Keratoconus Awareness Is Important and WE want to help people that suffer with this eye disease understand treatment options

What is the cornea and how does this relate to keratoconus? The cornea is the window and outer surface of the eye. When you are interpreting an image light travels through the cornea past the lens to the retina and then the brain to form a visual image. The normal corneal surface is smooth and aspheric and flattens towards the edges. Light rays passing through it moves in an undistorted manner to the retina to project a clear image to the brain. This is the typical normal working cornea.

Keratoconus is a very slow progressive eye condition that affects the cornea. The normally round, dome-shaped cornea weakens and thins, causing a cone-like bulge to develop. The regular curvature of the cornea becomes irregular, resulting in increasing nearsightedness (myopia) and astigmatism that have to be corrected with special glasses or contact lenses. Since the cornea is responsible for refracting most of the light coming into the eye, corneal abnormalities can result in significant visual impairment, making simple tasks like driving or reading books.

1. Scleral Contact Lenses Scleral lenses are large-diameter rigid gas permeable lenses. They can range from 14 mm to over 20 mm in diameter. They are called “scleral” lenses because they completely cover the cornea (the clear dome of tissue that covers the colored part of the eye) and extend onto the sclera (the white part of the eye that forms the outer wall of the eye).

2. Collagen Crosslinking (CXL)

Collagen crosslinking is a technique that is currently under FDA trial here in the United States, but widely available outside the country. Collagen crosslinking is a technique where vitamin B2 (also known as riboflavin) in liquid form is placed on the cornea. The cornea is then exposed to ultravioled light (UV-A). The combination of vitamin B2 and UV light increases the “linkages” in the corneal collagen. This has been shown in laboratory studies to “stiffen” the cornea. The goal of collagen crosslinking is to prevent progression of the keratoconus, not to reverse or cure it.

INTACS® Corneal Inserts

INTACS corneal inserts are small inserts that are placed in the cornea. These inserts help “flatten” the central cone of the cornea in patients with keratoconus. Once surgically implanted in the cornea the inserts are almost invisible and they cannot be felt. INTACS have been shown to help with improvement in corrected and uncorrected vision. INTACS can also be helpful in improving contact lens tolerance by reducing the conical shape of corneal in patients with keratoconus. Recent studies have shown continued improvement in patients having INTACS placed over the course of 1 year and there is some suggestion that they may help stabilize the cornea.

Corneal Transplant Surgery

Approximately 20% of patients with keratoconus will have progression to the degree where corneal surgery is necessary. The most common procedure performed is a full thickness corneal transplant also know as a penetrating keratoplasty (PKP). A corneal transplant, also known as a corneal graft, or as a penetrating keratoplasty, involves the removal of the central portion (called a button) of the diseased cornea and replacing it with a matched donor button of cornea. Corneal grafts are performed on patients with damaged or scarred corneas that prevent acceptable vision. This may be due to corneal scarring from disease or trauma. In this photo of a recent transplant, the fine V-shaped stitches can be seen clearly on the right side, though they extend all the way around the transplant.