About the disease

Keratoconus is an eye disease that makes the cornea bulge out into a cone shape, whereas the cornea in a healthy eye is more rounded, like a dome. The cornea is the outer lens of the eye, which is responsible for focusing on objects. Protein, also known as collagen, prevents the cornea from bulging out. However, with keratoconus, a lack of protein causes a decrease in antioxidants. As a result, there is not enough collagen in the eye, which would normally keep the cornea in place.

Keratoconus is believed to be a hereditary disease that usually manifests itself during a person’s teenage years, so it is useful to know if family members have also suffered from it. In some cases, keratoconus develops as a result of a severe allergy, where continuous rubbing of the eyes can damage the cornea. It is not possible to accurately predict how the malformation of the cornea will progress. In some people, the cornea just stops bulging out on its own and vision improves. In other people, keratoconus can affect both eyes and may even cause scarring of the cornea. Since this condition is relatively easy to detect, patients usually seek treatment in time, so the disease rarely leads to blindness.

Symptoms

• Blurred vision
• Changes in the eye’s structure
• Double vision  
• Seeing halos
• Irritability in the eye
• Eye bulges outwards in a cone shape

Diagnosis

• During a general examination the doctor will examine the patient’s eye to see if the cornea is bulging outwards. The doctor can also establish whether the patient’s vision is abnormal and whether they have double vision or see halos.
• Topography is an imaging test that determines whether the anatomical structure of the patient’s eye is abnormal and whether there are enough fibers in the cornea to keep it in place. It is recommended that children and teenagers have an annual check-up if their parents or relatives have a history of keratoconus.

Treatment

• Crosslinking is a microsurgical procedure that makes the cornea stronger. A special ophthalmic solution and light are used, to prevent the cornea from bulging out.
• Circular keratotomy is a surgical procedure that prevents corneal scarring, which would have a detrimental effect on the patient’s vision.
• A corneal transplant is performed if the cornea was damaged to the extent that it cannot be treated by the types of surgery listed above.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko